1336253004 NPI number — STEPHEN M. BARNETT, MD, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336253004 NPI number — STEPHEN M. BARNETT, MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN M. BARNETT, MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1336253004
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3525 PIEDMONT RD NE
Provider Second Line Business Mailing Address:
BLDG 7 SUITE 601
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30305-1578
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-842-5400
Provider Business Mailing Address Fax Number:
404-848-8669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 COLLIER RD NW
Provider Second Line Business Practice Location Address:
SUITE 1020
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-351-2112
Provider Business Practice Location Address Fax Number:
404-351-7211
Provider Enumeration Date:
08/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARNETT
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
404-351-2112

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  015350 , 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)





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