MEDICARE: ANN REBECCA BARTHOLOMEW PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA3830	MA
2	363A00000X	Physician Assistant	003302	OH
3	363A00000X	Physician Assistant	PA2016-0047	NM
4	363A00000X	Physician Assistant	0110-004577	VA
5	363A00000X	Physician Assistant	PA05207	TX
6	363A00000X	Physician Assistant	11181292-1206	UT
7	363A00000X	Physician Assistant	0010-10190	NC

General Provider Information

NPI Number	:	1356471767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN REBECCA BARTHOLOMEW PA

Provider Business Mailing Address
First Line	:	160 IRIS WAY
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3885
Country	:	US
Telephone Number	:	404-667-8370
Fax Number	:

Provider Business Practice Location Address
First Line	:	237 WHITE ST STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-6351
Country	:	US
Telephone Number	:	910-577-4968
Fax Number	:	910-577-2916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	11/06/2024

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Directions to “ ANN REBECCA BARTHOLOMEW PA” Practice Location

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