Healthcare Provider Details

I. General information

NPI: 1356344055
Provider Name (Legal Business Name): BEATRIZ ALEXIA BARRIENTOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIA BARRIENTOS M.D.

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 TOWN PARK BLVD.
EVANS GA
30809-3089
US

IV. Provider business mailing address

P.O BOX 1758
EVANS GA
30809-3089
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-2500
  • Fax: 706-854-2559
Mailing address:
  • Phone: 706-854-2500
  • Fax: 706-854-2559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number053669
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number031554
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number053669
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: