Individual
LUCAS BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7324
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0254
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85602
GA
Other
Enumeration date
05/25/2015
Last updated
06/10/2024
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