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General NPI Number Information
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NPI Number | 1528166972
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Entity Type | Individual
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Provider Name | GEORGE BRADFORD CABE
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 220 J L WHITE DR STE 120
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City | JASPER
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State | GA
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Zip | 30143-4894
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Country | US
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Telephone | 706-692-3539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 407
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City | VIDALIA
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State | GA
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Zip | 30475-0407
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Country | US
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Telephone | 912-537-4986
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Fax | 912-538-8166
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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 | 64194
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 204938
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License Number State | MA
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