Organization Name: | BARRY A. KOFFLER, M.D., P.C. |
NPI Number: | 1871746305 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY A. KOFFLER (PRESIDENT) |
Mailing Address: | 1295 Hembree Rd Suite 200 A Roswell |
State: | GA US |
Postal Code: | 300765721 |
Phone Number: | 7704751279 |
Fax Number: | 7704425444 |
NPI Enumeration Date: | 10/28/2008 |
NPI Last Update Date: | 10/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 019540 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |