# BARNESVILLE FAMILY MEDICINE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700918919
- **Authorized official:** DR. BERT P WALL M.D. (PRESIDENT CEO)
- **Authorized official phone:** (770) 358-3284

## Contact information

- **Practice address:** 526 COLLEGE DR, BARNESVILLE, GA 30204-1713
- **Practice address phone:** (770) 358-3284
- **Practice address fax:** (770) 358-1015
- **Mailing address:** PO BOX 4867, MACON, GA 31208-4867
- **Mailing address phone:** (770) 358-3284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | GA | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 08/22/2020