Individual
JASON BARHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2111 CAVANAUGH AVE SE, ATLANTA, GA 30316-2705
(706) 836-8526
Mailing address
2111 CAVANAUGH AVE SE, ATLANTA, GA 30316-2705
(706) 836-8526
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN209107
GA
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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