Individual
ROBERT T. O'BANNON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13040 ABERCORN ST, SUITE 2, SAVANNAH, GA 31419-1955
(770) 645-9181
(770) 645-8455
Mailing address
80 NEWNAN STATION DR, STE A, NEWNAN, GA 30265-3194
(770) 814-6011
(770) 814-6011
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
060309
GA
207L00000X
Anesthesiology Physician
22326
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433679505B
—
GA
Enumeration date
07/25/2006
Last updated
08/10/2021
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