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NPI Code Detail

MEDICARE: DR. SIDNEY J BARNES-O'GORMAN D.C.

MEDICARE: DR. SIDNEY J BARNES-O'GORMAN D.C.
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
1111NR0400XRehabilitation ChiropractorCHIRO02094GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CHIRO02094OTHERGAGA LICENSE

General Provider Information

NPI Number : 1518036920
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIDNEY J BARNES-O'GORMAN D.C.
Provider Business Mailing Address
First Line : 3155 ROSWELL RD NE STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30305-1836
Country : US
Telephone Number : 404-231-1000
Fax Number : 404-231-5546
Provider Business Practice Location Address
First Line : 3155 ROSWELL RD NE STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30305-1836
Country : US
Telephone Number : 404-231-1000
Fax Number : 404-231-5546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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