Doctor Name: | CARLEY S EBANKS |
NPI Number: | 1558301341 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 035619 |
Business Practice Address: | 610 3rd St Ste 100 Macon, GA - 312013293 |
Business Phone Number: | 4784642600 |
Business Fax Number: | 4788034281 |
Mailing Address: | 610 3rd St Ste 100, MACON |
State: | GA |
Postal Code: | 312013293 |
Phone Number: | 4784642600 |
Fax Number: | 4788034281 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 09/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 035619 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |