MEDICARE: DR. BRYANT KEITH BARROWS D.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	122300000X	Dentist	DN011215	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN011215	OTHER	GA	STATE LICENSE

General Provider Information

NPI Number	:	1497862544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYANT KEITH BARROWS D.M.D.

Provider Business Mailing Address
First Line	:	400 S 3RD AVE
Second Line	:
City	:	MC RAE
State	:	GA
Zip	:	31055-1760
Country	:	US
Telephone Number	:	229-868-4462
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S 3RD AVE
Second Line	:
City	:	MC RAE
State	:	GA
Zip	:	31055-1760
Country	:	US
Telephone Number	:	229-868-4462
Fax Number	:

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. BRYANT KEITH BARROWS D.M.D.” Practice Location

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