Individual
CLINTON BANCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3200 DOWNWOOD CIR NW, SUITE 200, ATLANTA, GA 30327-1610
(404) 355-8721
(404) 355-8797
Mailing address
1434 N MORNINGSIDE DR NE, ATLANTA, GA 30306-3240
(404) 876-1514
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN035321
GA
Other
Enumeration date
08/25/2005
Last updated
07/08/2007
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