Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 59002 | GA |
NPI | 1003946468 |
---|---|
Provider Name | Dr. Robert Price III |
First Address | Watkinsville, GA 30677-4847 |
Second Address | Watkinsville, GA 30677-4847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 11/12/2020 |