MEDICARE: TAMMY S BARNES

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	172A00000X	Driver	1582	AL
2	172A00000X	Driver	9063	AL

General Provider Information

NPI Number	:	1730479684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY S BARNES

Provider Business Mailing Address
First Line	:	3216 ETHEL AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-1128
Country	:	US
Telephone Number	:	706-580-6777
Fax Number	:	706-653-8434

Provider Business Practice Location Address
First Line	:	3216 ETHEL AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-1128
Country	:	US
Telephone Number	:	706-580-6777
Fax Number	:	706-653-8434

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

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	04/12/2011

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Directions to “ TAMMY S BARNES ” Practice Location

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