Healthcare Provider Details

I. General information

NPI: 1184247785
Provider Name (Legal Business Name): ANDREW TYLER BARNES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 PINE ST STE 750
MACON GA
31201-7528
US

IV. Provider business mailing address

840 PINE ST STE 750
MACON GA
31201-7528
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-1458
  • Fax: 478-633-5025
Mailing address:
  • Phone: 478-633-1458
  • Fax: 478-633-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number109462
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: