Doctor Name: | ROBERT I BOURNE |
NPI Number: | 1174513303 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD2641 |
Business Practice Address: | 101 Hospital Dr Camden, TN - 383201617 |
Business Phone Number: | 7315842020 |
Business Fax Number: | |
Mailing Address: | 101 Hospital Dr, CAMDEN |
State: | TN |
Postal Code: | 383201617 |
Phone Number: | 7315842020 |
Fax Number: | 7315842022 |
NPI Enumeration Date: | 10/27/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD2641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |