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Individual

MRS. BARBARA JANE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
3530 SCHOONER RDG, ALPHARETTA, GA 30005-4258
(770) 475-3574

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1005569
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1005569
PA CERTIFICATION NUMBER
GA
01
36
36
Enumeration date
07/03/2006
Last updated
07/08/2007
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