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Organization
J. DAVID BANNON MD PC
Active
Organization
J. DAVID BANNON MD PC
Active
Other names
BANNON ORTHOPAEDICS & SPORTS MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J DAVID BANNON MD (PRESIDENT)
(518) 761-2663
Entity
Organization
Contact information
Practice address
543 BAY RD, QUEENSBURY, NY 12804-1441
(518) 761-2663
(518) 761-6831
Mailing address
543 BAY RD, QUEENSBURY, NY 12804-1441
(518) 761-2663
(518) 761-2663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
136663
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00832751
—
NY
Enumeration date
07/11/2006
Last updated
08/22/2020
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