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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EBON ANTHONY BOURNE MD PA

Active Organization

EBON ANTHONY BOURNE MD PA is a Multi-Specialty Clinic organization located in MARIETTA, Georgia. NPI 1043494479 is currently active in the NPPES registry. Verify at CMS.

Multi-Specialty Clinic · MARIETTA, GA

Registration Details

NPI Number
1043494479
Provider Type
Organization
NPI Issued
Dec 20, 2007 (18.468265783154 yrs)
Last Updated
Mar 20, 2015
Licenses
ME84326 (FL)
68373 (GA)

Practice Information

Address
2594 WEDDINGTON RDG NE
MARIETTA, GA, 300682283
Browse GA providers · Browse ZIP 30068
Phone
9548958240
Fax
6785045346
Primary Specialty
Multi-Specialty Clinic
261QM1300X
Additional Specialty
Multi-Specialty Clinic
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.