Healthcare Provider Details

I. General information

NPI: 1205743705
Provider Name (Legal Business Name): JAMES BARKSDALE ANDERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 PATHERSVILLE ROAD
DECATUR GA
30034
US

IV. Provider business mailing address

1256 N MORNINGSIDE DR NE
ATLANTA GA
30306-3335
US

V. Phone/Fax

Practice location:
  • Phone: 404-243-2230
  • Fax: 404-212-4657
Mailing address:
  • Phone: 404-243-2230
  • Fax: 404-212-4657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number014038
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: