| Doctor Name: | DR. ROBERT LEE EBELING |
| NPI Number: | 1285896936 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | N3627 |
| Business Practice Address: | 1255 Highway 54 W Bldg. 1267, Suite 1100 Fayetteville, GA - 302144526 |
| Business Phone Number: | 7707195850 |
| Business Fax Number: | |
| Mailing Address: | 1255 Highway 54 W, Bldg. 1267, Suite 1100 FAYETTEVILLE |
| State: | GA |
| Postal Code: | 302144526 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2008 |
| NPI Last Update Date: | 05/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | N3627 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |