Healthcare Provider Details

I. General information

NPI: 1285096420
Provider Name (Legal Business Name): MATTHEW ALAN BARNES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 18TH ST
COLUMBUS GA
31901-1524
US

IV. Provider business mailing address

777 HEMLOCK ST
MACON GA
31201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 706-649-6600
  • Fax:
Mailing address:
  • Phone: 478-633-6272
  • Fax: 478-633-6269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number87924
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number90919
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number90919
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: