Healthcare Provider Details

I. General information

NPI: 1083636351
Provider Name (Legal Business Name): BARBARA H MCCOLLUM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA COLLEEN HARVEY

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 S BROAD ST
THOMASVILLE GA
31792-6198
US

IV. Provider business mailing address

918 S BROAD ST
THOMASVILLE GA
31792-6198
US

V. Phone/Fax

Practice location:
  • Phone: 229-226-8800
  • Fax: 229-228-7005
Mailing address:
  • Phone: 229-226-8800
  • Fax: 229-228-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number054621
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number054621
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number054621
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: