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General NPI Number Information
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NPI Number | 1760616320
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Entity Type | Organization
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Legal Business Name | O'BARR INTERNAL MEDICINE, PC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 07/24/2021
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Provider Practice Location Address
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Address Line | 2032 SHADY FALLS RD
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City | BLUE RIDGE
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State | GA
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Zip | 30513-5578
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Country | US
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Telephone | 404-275-6383
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Fax |
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Provider Business Mailing Address
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Address Line | 96 CRAIG ST STE 112
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City | EAST ELLIJAY
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State | GA
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Zip | 30540-8612
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Country | US
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Telephone | 404-275-6383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS B O'BARR JR.
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Credential | M.D.
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Telephone | 404-275-6383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 024472
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License Number State | GA
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