Individual
BARBARA EILEEN EBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
760 26TH AVE SE, MOULTRIE, GA 31768-6799
(229) 502-9710
Mailing address
PO BOX 3864, MOULTRIE, GA 31776-3864
(229) 502-9710
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
071730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147858B
—
GA
05
—
003147858D
—
GA
01
—
202I075536
MEDICARE PTAN
GA
Enumeration date
05/04/2006
Last updated
07/21/2022
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