Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 045040 | GA |
NPI | 1003808619 |
---|---|
Provider Name | Amy L Barfield |
First Address | Marietta, GA 30066-6340 |
Second Address | Roswell, GA 30076-4946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 05/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00815251A | (05) | GA |
H00712 | (02) | GA |