Provider Demographics
NPI:1417088600
Name:DOURRON, ROBERT PIERRE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PIERRE
Last Name:DOURRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 N DECATUR RD STE 301
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6132
Mailing Address - Country:US
Mailing Address - Phone:404-294-0472
Mailing Address - Fax:404-294-1558
Practice Address - Street 1:2675 N DECATUR RD STE 301
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6132
Practice Address - Country:US
Practice Address - Phone:404-294-0472
Practice Address - Fax:404-294-1558
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048617207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000873386AMedicaid
H28130Medicare UPIN
GA000873386AMedicaid