1215930417 NPI number — DR. RAYMOND C BARFIELD MD

Table of content: DR. RAYMOND C BARFIELD MD (NPI 1215930417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215930417 NPI number — DR. RAYMOND C BARFIELD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARFIELD
Provider First Name:
RAYMOND
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215930417
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4700 WATERS AVE STE 507
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31404-6220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-350-4752
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 WATERS AVE STE 507
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31404-6220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-350-4752
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X , with the licence number:  32030 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0207X , with the licence number: 2008-01313 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0002X , with the licence number: 39043 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200035470A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5440212 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010170231 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 204753313 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 174369201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200335860A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009932324 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 422400000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03105248 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200093280A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64085566 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104763277 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 139014001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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