MEDICARE: DR. REBECCA FAITH BARKSDALE M.D.

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	207Q00000X	Family Medicine Physician	20640	SC

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	:	1215915343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA FAITH BARKSDALE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 8618
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29604-8618
Country	:	US
Telephone Number	:	864-232-6689
Fax Number	:	864-232-3584

Provider Business Practice Location Address
First Line	:	135 COMMONS WAY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-3850
Country	:	US
Telephone Number	:	864-232-6689
Fax Number	:	864-232-3584

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/13/2010

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