Individual
BANNESTER LESTER HARBIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
(706) 236-6432
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
010184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000038673A
—
GA
Enumeration date
12/12/2006
Last updated
06/30/2010
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