Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 013971 | GA |
Y | 207RP1001X | Pulmonary Disease | 013971 | GA |
NPI | 1295896546 |
---|---|
Provider Name | Buford Goodwin Harbin |
First Address | Rome, GA 30165-1625 |
Second Address | Rome, GA 30165-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 07/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000152094A | (05) | GA |
D29684 | (02) |