MEDICARE: NICHOLAS BARRINGER RD

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	133V00000X	Registered Dietitian	DT07537	TX

General Provider Information

NPI Number	:	1841418068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS BARRINGER RD

Provider Business Mailing Address
First Line	:	6300 MILGEN RD APT 1159
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-7575
Country	:	US
Telephone Number	:	254-702-2772
Fax Number	:

Provider Business Practice Location Address
First Line	:	MARTIN ARMY COMMUNITY HOSPITAL
Second Line	:	7950 MARTIN LOON
City	:	FORT BENNING
State	:	GA
Zip	:	31905-5637
Country	:	US
Telephone Number	:	706-544-2273
Fax Number	:

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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