Individual
EDGAR ROBIN BOHANNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF AUDIOLOGY
Contact information
Practice address
1215 GEORGE C WILSON DR, SUITE 3A, AUGUSTA, GA 30909-5700
(706) 364-2384
(706) 364-2380
Mailing address
1215 GEORGE C WILSON DR, SUITE 3A, AUGUSTA, GA 30909-5700
(706) 364-2384
(706) 364-2380
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
65
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
703515
BLUE SHIELD PROVIDER NO
GA
Enumeration date
04/17/2006
Last updated
07/08/2007
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