Brandon M Barbery

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fort Gordon, GA

NPI 1346988458 · NPPES record last updated Oct 9, 2023

Key facts

NPI
1346988458
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
97486 (GA)
Practice address
300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone
(703) 232-5687
NPI assigned
May 27, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231019002049 GA Order and Referring Only - Orthopedic Surgery
Practitioner - Orthopedic Surgery
2668828195

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
97486GAMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 97486 GA Yes
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

300 East Hospital Road
Fort Gordon, GA 30905-5650

Mailing address

300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone (706) 787-1647

Other providers in Fort Gordon, GA

All providers in Fort Gordon, GA · Student in an Organized Health Care Education/Training Program in Georgia

Sources for this page

Verify at the official NPI Registry.