Provider Demographics
NPI:1336253004
Name:STEPHEN M. BARNETT, MD, PC
Entity type:Organization
Organization Name:STEPHEN M. BARNETT, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-351-2112
Mailing Address - Street 1:3525 PIEDMONT RD NE
Mailing Address - Street 2:BLDG 7 SUITE 601
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1578
Mailing Address - Country:US
Mailing Address - Phone:404-842-5400
Mailing Address - Fax:404-848-8669
Practice Address - Street 1:105 COLLIER RD NW
Practice Address - Street 2:SUITE 1020
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1710
Practice Address - Country:US
Practice Address - Phone:404-351-2112
Practice Address - Fax:404-351-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015350208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP494Medicare PIN
GA01000Medicare PIN