MEDICARE: MR. CHARLES GARRETT BARNES P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9104788	FL
2	363A00000X	Physician Assistant	PA1096	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194756668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES GARRETT BARNES P.A.

Provider Business Mailing Address
First Line	:	1040 GULF BREEZE PKWY STE 209
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-7808
Country	:	US
Telephone Number	:	850-916-3700
Fax Number	:	850-916-3710

Provider Business Practice Location Address
First Line	:	1040 GULF BREEZE PKWY STE 209
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-7808
Country	:	US
Telephone Number	:	850-916-3700
Fax Number	:	850-916-3710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	03/07/2023

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Directions to “ MR. CHARLES GARRETT BARNES P.A.” Practice Location

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