Individual
DR. EBON ANTHONY BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3225 CUMBERLAND BLVD SE STE 550, ATLANTA, GA 30339-6069
(404) 419-9970
(404) 252-8930
Mailing address
3225 CUMBERLAND BLVD SE STE 550, ATLANTA, GA 30339-6069
(404) 419-9970
(404) 252-8930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
068373
GA
207R00000X
Internal Medicine Physician
68373
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68373
LICENSE
GA
Enumeration date
02/06/2007
Last updated
06/25/2025
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