Individual
LAURA BANKS GOBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(762) 235-2700
(706) 236-6437
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005784
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701938069A
—
GA
05
—
701938069B
—
GA
05
—
701938069C
—
GA
05
—
701938069D
—
GA
05
—
701938069E
—
GA
05
—
701938069F
—
GA
Enumeration date
02/09/2010
Last updated
04/24/2020
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