Bannon, Richard Bruce

Bannon, Richard Bruce is an individual health care provider with primary practice located at 391 Glenn Springs Rd , Pacolet SC 29372-2417. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bannon, Richard Bruce can be contacted via phone (864) 474-3013.

Contact Information

Primary practice address
391 Glenn Springs Rd Pacolet SC 29372-2417
Phone: (864) 474-3013
Fax: (864) 474-1501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 7239 South Carolina

Profile Details

NPI number 1912959362
LBN Legal business name Bannon, Richard Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Sep 7th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912959362 NPPES
Georgia Other P00386835 MEDICARE RAILROAD PTAN#
Georgia MEDICAID 072398 MEDICARE RAILROAD PTAN#

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