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General NPI Number Information
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NPI Number | 1861492829
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Entity Type | Individual
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Provider Name | MARJORIE LEE BARNETT MD MBA
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 449 WEST 23RD ST
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone | 850-769-8341
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 1ST ST N APT 305
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-8403
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Country | US
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Telephone | 845-701-6677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 155839
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License Number State | NY
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