Provider Demographics
NPI:1467463513
Name:BOND, TOBY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:M
Last Name:BOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1181 LANGFORD DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7242
Mailing Address - Country:US
Mailing Address - Phone:706-548-9655
Mailing Address - Fax:706-548-9672
Practice Address - Street 1:1181 LANGFORD DR STE 105
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7242
Practice Address - Country:US
Practice Address - Phone:706-548-9655
Practice Address - Fax:706-548-9672
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA43880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00753585JMedicaid
GA11BDWGNMedicare ID - Type Unspecified
GA00753585JMedicaid