Individual
DR. GERALD WAYNE BOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2706 WATSON BLVD, SUITE D, WARNER ROBINS, GA 31093-2997
(478) 953-6033
(478) 953-6047
Mailing address
1415 PARK AVE, PERRY, GA 31069-2311
(478) 987-3417
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
10105
GA
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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