1699754887 NPI number — ROBERT BRETT BARGER MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699754887 NPI number — ROBERT BRETT BARGER MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BARGER

Provider First Name:

ROBERT

Provider Middle Name:

BRETT

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1699754887

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/26/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 658

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GAINESVILLE

Provider Business Mailing Address State Name:

GA

Provider Business Mailing Address Postal Code:

30503-0658

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

770-718-1122

Provider Business Mailing Address Fax Number:

770-535-7445

Provider First Line Business Practice Location Address:

725 JESSE JEWELL PKWY SE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

GAINESVILLE

Provider Business Practice Location Address State Name:

GA

Provider Business Practice Location Address Postal Code:

30501-3834

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

770-297-2200

Provider Business Practice Location Address Fax Number:

770-534-8139

Provider Enumeration Date:

01/16/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207V00000X , with the licence number:  047052 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000825525H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000825525K , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0701224 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 10045017 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 7728639 . This is a "CIGNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 7982851 . This is a "AETNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 329317 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 0701224 . This is a "UHC" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: 000825525D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000825525I , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 52666781 . This is a "BCBS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
• Identifier: P00214243 . This is a "RR MEDICARE-GRP # CC4177" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".