Doctor Name: | DR. ROBERT J PEZZIN |
NPI Number: | 1144241944 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 21785 |
Business Practice Address: | 102 Wiley Dr Cedartown, GA - 301252259 |
Business Phone Number: | 7707488940 |
Business Fax Number: | 7707482151 |
Mailing Address: | 102 Wiley Dr, CEDARTOWN |
State: | GA |
Postal Code: | 301252259 |
Phone Number: | 7707488940 |
Fax Number: | 7707482151 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 06/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 21785 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |