Individual
GARY MARC WETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 RIVERSIDE PKWY NE, SUITE 200, ROME, GA 30161-2902
(706) 291-4334
(706) 291-0248
Mailing address
PO BOX 468, ROME, GA 30162-0468
(706) 291-4334
(706) 291-0248
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
030690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000393137A
—
GA
05
—
000393137B
—
GA
Enumeration date
12/27/2006
Last updated
02/24/2009
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