MEDICARE: MR. JOHN BRANDON BARRON M.ED.

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	235Z00000X	Speech-Language Pathologist	SLP004105	GA

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
2	SLP004105	OTHER	FL	SPEECH THERAPY LICENSE

General Provider Information

NPI Number	:	1265595839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN BRANDON BARRON M.ED.

Provider Business Mailing Address
First Line	:	80 ALDEN AVE NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2007
Country	:	US
Telephone Number	:	404-543-5434
Fax Number	:	404-876-2909

Provider Business Practice Location Address
First Line	:	5041 DALLAS HWY
Second Line	:	SUITE 704-C
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-6458
Country	:	US
Telephone Number	:	678-331-3041
Fax Number	:	404-876-2909

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/09/2007

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Directions to “ MR. JOHN BRANDON BARRON M.ED.” Practice Location

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