Healthcare Provider Details

I. General information

NPI: 1720473820
Provider Name (Legal Business Name): JAMES BARKSDALE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 WHITE SULPHUR RD STE 120
GAINESVILLE GA
30501-2569
US

IV. Provider business mailing address

PO BOX 742616
ATLANTA GA
30374-2616
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-9320
  • Fax:
Mailing address:
  • Phone: 770-219-8420
  • Fax: 931-762-4499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number860
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number860
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD305040
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: