Provider Demographics
NPI:1194763292
Name:COMBSBARNES, DELORES ANN (DPM)
Entity type:Individual
Prefix:DR
First Name:DELORES
Middle Name:ANN
Last Name:COMBSBARNES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 CHATEAU FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-6232
Mailing Address - Country:US
Mailing Address - Phone:678-859-8902
Mailing Address - Fax:770-307-1443
Practice Address - Street 1:4704 CHATEAU FOREST WAY
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-6232
Practice Address - Country:US
Practice Address - Phone:678-859-8902
Practice Address - Fax:770-307-1443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000730213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00615315AMedicaid
GA00615315AMedicaid
GA48SCBMJMedicare ID - Type Unspecified