Ebon Anthony Bourne Md Pa in Marietta - Multi-specialty
Ebon Anthony Bourne Md Pa - NPI 1043494479
Ebon Anthony Bourne Md Pa is a Multi-specialty in Marietta, Georgia. Ebon Anthony Bourne Md Pa practices all healthcare services and medical treatments related to Multi-specialty. The NPI Number for Ebon Anthony Bourne Md Pa is 1043494479. The last update date is 2015-03-20.
Ebon Anthony Bourne Md Pa's current location address is 2595 Weddington Ridge, Marietta, Georgia. You can contact this provider via phone number 9548958240 and fax number 6785045346. The mailing address for Ebon Anthony Bourne Md Pa is 2595 Weddington Ridge, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ebon Anthony Bourne Md Pa |
|---|---|
| Address | 2595 Weddington Ridge, Marietta, Georgia |
| Phone Number | 9548958240 |
| Fax Number | 6785045346 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MD/OWNER |
|---|---|
| Authorized Official Name | Bourne Anthony Ebon |
| Credentials | MD |
| Telephone Number | 9548958240 |
NPI Number Detail
| NPI Number | 1043494479 |
|---|---|
| Provider Enumeration Date | 2007-12-20 |
| Last Updated Date | 2015-03-20 |
Provider Mailing Address Detail
| Address | 2595 Weddington Ridge |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 30068 |
| Phone Number | 9548958240 |
| Fax Number | 6785045346 |
Provider's Primary Taxonomy Detail
| Speciality | Multi-specialty |
|---|---|
| Taxonomy | 261Qm1300X |
| Licence No | 68373 |
|
Definition: Provides integrated outpatient care across medical and surgical specialties with referrals under one roof. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 265092400 | FL | -- |
Post Comment/ Review Below
What is the Ebon Anthony Bourne Md Pa's unique identification number?
The Ebon Anthony Bourne Md Pa has been assigned the NPI (National Provider Identifier) Number 1043494479 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Ebon Anthony Bourne Md Pa's physical address?
The Ebon Anthony Bourne Md Pa is physically located at 2595 Weddington Ridge, in the city of Marietta, GA, with the postal code 30068.
What is Ebon Anthony Bourne Md Pa's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Ebon Anthony Bourne Md Pa is Multi-specialty, and the taxonomy code that categorizes this field of expertise is 261Qm1300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1043494479 to Ebon Anthony Bourne Md Pa?
The Centers for Medicare & Medicaid Services originally issued the 1043494479 to Ebon Anthony Bourne Md Pa on 2007-12-20.
When was the information regarding Ebon Anthony Bourne Md Pa, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Ebon Anthony Bourne Md Pa, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2015-03-20.
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