Provider Demographics
NPI:1194802769
Name:BARBER, JAMES DENNIS (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DENNIS
Last Name:BARBER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5165 COOK ST NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-6207
Mailing Address - Country:US
Mailing Address - Phone:770-787-2400
Mailing Address - Fax:770-787-4000
Practice Address - Street 1:5165 COOK ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-6207
Practice Address - Country:US
Practice Address - Phone:770-787-2400
Practice Address - Fax:770-787-4000
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1004-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU05532Medicare UPIN