Healthcare Provider Details

I. General information

NPI: 1851828479
Provider Name (Legal Business Name): JEFFREY BARKHOUSE FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 05/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 2ND AVE
COLUMBUS GA
31904-7408
US

IV. Provider business mailing address

3702 2ND AVE
COLUMBUS GA
31904-7408
US

V. Phone/Fax

Practice location:
  • Phone: 706-507-9209
  • Fax: 706-507-9249
Mailing address:
  • Phone: 706-507-9209
  • Fax: 706-507-9249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN100292
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: