Basic Information
| Provider Information | |||||||||
| NPI: | 1245251081 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRON | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | TALBERT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60114 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282600114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033295131 | ||||||||
| FaxNumber: | 8033666600 | ||||||||
| Practice Location | |||||||||
| Address1: | 2633 CELANESE RD | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297321205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033295131 | ||||||||
| FaxNumber: | 8033666600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 11/24/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 19059 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 9800465 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1182P | 01 | NC | BLUE CROSS BLUE SHIELD NC | OTHER | 190590 | 05 | SC | MEDICAID | 080109449 | 01 | RAILROAD MEDICARE | OTHER |