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General NPI Number Information
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NPI Number | 1063466803
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Entity Type | Individual
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Provider Name | RONALD BRADBURN VINCENT PEARSON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 2855 OLD HIGHWAY 5 STE 108
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City | BLUE RIDGE
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State | GA
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Zip | 30513-6239
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Country | US
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Telephone | 706-632-4217
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Fax | 706-632-4244
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Provider Business Mailing Address
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Address Line | 2855 OLD HIGHWAY 5 STE 108
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City | BLUE RIDGE
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State | GA
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Zip | 30513-6239
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Country | US
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Telephone | 706-632-4217
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Fax | 706-632-4244
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 110203
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 20152
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License Number State | WV
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