Provider Demographics
NPI:1457441644
Name:GARTMOND, CINDY O'BRYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:O'BRYANT
Last Name:GARTMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3530
Mailing Address - Country:US
Mailing Address - Phone:478-299-6992
Mailing Address - Fax:
Practice Address - Street 1:1570 BRAMPTON AVE
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0855
Practice Address - Country:US
Practice Address - Phone:912-764-9196
Practice Address - Fax:912-764-8401
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037545208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00581776DMedicaid
GA00581776DMedicaid