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Individual

CARLEY S EBANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
610 3RD ST STE 202, MACON, GA 31201
(478) 464-2600
(478) 803-4281
Mailing address
610 3RD ST STE 100, MACON, GA 31201-3293
(478) 464-2600
(478) 803-4281

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
035619
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000506569A
GA
Enumeration date
06/08/2006
Last updated
05/23/2018
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