Healthcare Provider Details

I. General information

NPI: 1881841351
Provider Name (Legal Business Name): SHON BARNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 COMER AVE
COLUMBUS GA
31904-8725
US

IV. Provider business mailing address

5825 THEA LN APT.. A-15
COLUMBUS GA
31907-2460
US

V. Phone/Fax

Practice location:
  • Phone: 706-596-5583
  • Fax: 706-596-5589
Mailing address:
  • Phone: 706-615-7329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: