Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 049878 | GA |
NPI | 1033100326 |
---|---|
Provider Name | Dr. Barbara Lynn Menchan |
First Address | Atlanta, GA 30368-7337 |
Second Address | Columbus, GA 31901-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 01/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000922523D | (05) | GA |