Ebon Anthony Bourne Md Pa
LBN: Ebon Anthony Bourne Md Pa
Ebon Anthony Bourne Md Pa is an health care organization with primary practice located at 2594 Weddington Rdg Ne , Marietta GA 30068-2283. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Ebon Anthony Bourne Md Pa can be contacted via phone (954) 895-8240, or through Bourne, Ebon Anthony via phone (954) 895-8240.
Contact Information
Primary practice address
2594 Weddington Rdg Ne
Marietta GA 30068-2283
Phone: (954) 895-8240
Fax: (678) 504-5346
Website:
Authorized official contact:
Name: Bourne, Ebon Anthony Doctor of Medicine (MD)
Phone: (954) 895-8240
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME84326 | Florida |
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | 68373 | Georgia |
Profile Details
| NPI number | 1043494479 |
|---|---|
| LBN Legal business name | Ebon Anthony Bourne Md Pa |
| DBA Doing business as | |
| Authorized official | Bourne, Ebon Anthony Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 20th, 2007 |
| Last updated | Mar 20th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043494479 | NPPES |
| Florida | MEDICAID | 265092400 |
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