Basic Information
| Provider Information | |||||||||
| NPI: | 1699731240 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C/SA | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 1380 | ||||||||
| Address2: | |||||||||
| City: | ANNISTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562355860 | ||||||||
| FaxNumber: | 2562355190 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 LEIGHTON AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ANNISTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562361300 | ||||||||
| FaxNumber: | 2562360254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2006 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA-4 | AL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363A00000X | PA-4 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.