=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205743705
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES BARKSDALE ANDERSON
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2026
-----------------------------------------------------
Last Update Date | 08/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3073 PATHERSVILLE ROAD
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-243-2230
-----------------------------------------------------
Fax | 404-212-4657
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1256 N MORNINGSIDE DR NE
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30306-3335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-243-2230
-----------------------------------------------------
Fax | 404-212-4657
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P1300X
-----------------------------------------------------
Taxonomy Name | Psychiatric Pharmacist
-----------------------------------------------------
License Number | 014038
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------