MEDICARE: MR. TONY F. BARNETT JR. ATC

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	2255A2300X	Athletic Trainer	1656	TN

General Provider Information

NPI Number	:	1578624649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TONY F. BARNETT JR. ATC

Provider Business Mailing Address
First Line	:	1055 PINE ST APT 262
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-4092
Country	:	US
Telephone Number	:	615-483-6810
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 FIELD HOUSE
Second Line	:	ALL-AMERICAN DRIVE
City	:	UNIVERSITY
State	:	MS
Zip	:	38677-1848
Country	:	US
Telephone Number	:	662-915-7536
Fax Number	:	662-915-5275

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	12/08/2014

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