Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 041718 | GA |
NPI | 1063410173 |
---|---|
Provider Name | Dr. Anthony Edward Barnes |
First Address | Atlanta, GA 30305-1736 |
Second Address | Atlanta, GA 30315-7129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000700499E | (05) | GA |
1063410173 | BLUE CROSS BLUE SHIELD (01) | GA |
1916108 | UNITED HEALTHCARE (01) | GA |
331185 | WELLCARE (01) | GA |
5244142 | AETNA (01) | GA |
F66762 | (02) | GA |