Provider Demographics
NPI:1518998210
Name:GARNETT, ROBERT P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GARNETT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1125 TROUPE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4480
Mailing Address - Country:US
Mailing Address - Phone:706-737-4575
Mailing Address - Fax:706-731-5289
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6521
Practice Address - Country:US
Practice Address - Phone:706-651-2369
Practice Address - Fax:706-651-2364
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA048046207P00000X, 207PE0004X, 207PP0204X, 207PS0010X, 207Q00000X, 207QA0000X, 207QA0505X, 207QG0300X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
345597OtherWELLCARE OF GA
10062907OtherAMERIGROUP
1447352778OtherNPI - CSRA EMERGENCY PHYS
345597OtherWELLCARE OF GA
GA93BFCHPMedicare PIN