Healthcare Provider Details

I. General information

NPI: 1730127598
Provider Name (Legal Business Name): JONATHAN BLAIR BARNES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 DEEP SOUTH FARM RD SUITE 100
BLAIRSVILLE GA
30512-2218
US

IV. Provider business mailing address

PO BOX 116470
ATLANTA GA
30368-6470
US

V. Phone/Fax

Practice location:
  • Phone: 706-835-3030
  • Fax: 706-835-3028
Mailing address:
  • Phone: 770-682-2099
  • Fax: 866-423-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number051430
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number051430
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: