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1770131104
KENNETH BROOKE BINGHAM
ROME, GA
NPI
1770131104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant Surgical
(Licence: GA 9270)
Enumeration Date
2019-08-28
Last Update Date
2019-10-10
Business Address
KENNETH BROOKE BINGHAM PA
100 THREE RIVERS DR NE STE A
ROME, GA 30161-4999
Phone number: 709-292-0040
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Mailing Address
KENNETH BROOKE BINGHAM PA
4600 ROSWELL RD UNIT 515
ATLANTA, GA 30342-3091
Phone number:
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