Individual
DR. MCKINLEY THEODORE BAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1930 POWDER SPRINGS RD SW, SUITE 1120, MARIETTA, GA 30064-4324
(770) 427-7800
(470) 427-6565
Mailing address
1930 POWDER SPRINGS RD SW, SUITE 1120, MARIETTA, GA 30064-4324
(770) 427-7800
(470) 427-6565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
046826
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
046826
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00860021D
—
GA
Enumeration date
08/01/2006
Last updated
05/16/2025
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