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General NPI Number Information
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NPI Number | 1265512875
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Entity Type | Individual
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Provider Name | JAMES R BAUERBAND MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 355 CLEAR CREEK PKWY STE 1003
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City | LAVONIA
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State | GA
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Zip | 30553-4271
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Country | US
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Telephone | 706-356-0780
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Fax | 706-356-0781
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Provider Business Mailing Address
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Address Line | PO BOX 48089
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City | ATHENS
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State | GA
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Zip | 30604-8089
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Country | US
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Telephone | 706-389-3740
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Fax | 706-389-3951
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 32692
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License Number State | GA
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