MEDICARE: CHRISTOPHER BERNARD BARBER IDC

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	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1891763777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER BERNARD BARBER IDC

Provider Business Mailing Address
First Line	:	126 LAKE MANOR DR
Second Line	:
City	:	KINGSLAND
State	:	GA
Zip	:	31548-6274
Country	:	US
Telephone Number	:	904-270-6515
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS PHILIPPINE SEA
Second Line	:
City	:	FPO
State	:	AA
Zip	:	34092-1178
Country	:	US
Telephone Number	:	902-270-6515
Fax Number	:

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/21/2022

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