Provider Demographics
NPI:1942414057
Name:BARNETT, ELISE P (MD)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:P
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELISE
Other - Middle Name:P
Other - Last Name:LIRETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW STE 680
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0920
Mailing Address - Country:US
Mailing Address - Phone:404-446-4840
Mailing Address - Fax:404-446-4841
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 680
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0920
Practice Address - Country:US
Practice Address - Phone:404-446-4840
Practice Address - Fax:404-446-4841
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA081099207N00000X, 207N00000X
TXN3840207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
511-10983OtherBLUE CROSS
AL528501290Medicaid
ALCM4358OtherRR MCR
631066099OtherFED TAX #
45-3970660OtherFED TAX #
AL511-30216OtherBCBS
AL528501290Medicaid