Healthcare Provider Details

I. General information

NPI: 1396558110
Provider Name (Legal Business Name): MAGGIE ELIZABETH BARRETT PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 E SOUTH BLVD STE 601
MONTGOMERY AL
36116-2014
US

IV. Provider business mailing address

8249 WEXFORD TRCE
MONTGOMERY AL
36117-8207
US

V. Phone/Fax

Practice location:
  • Phone: 334-747-2273
  • Fax:
Mailing address:
  • Phone: 770-653-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: