Provider Demographics
NPI:1679653950
Name:ROBERT E. SPRINGER III M.D. P.C
Entity Type:Organization
Organization Name:ROBERT E. SPRINGER III M.D. P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:404-920-6201
Mailing Address - Street 1:50 EXECUTIVE PARK SOUTH NE
Mailing Address - Street 2:SUITE 5012
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2214
Mailing Address - Country:US
Mailing Address - Phone:404-920-6201
Mailing Address - Fax:404-920-6205
Practice Address - Street 1:50 EXECUTIVE PARK SOUTH NE
Practice Address - Street 2:SUITE 5012
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2214
Practice Address - Country:US
Practice Address - Phone:404-920-6201
Practice Address - Fax:404-920-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037081207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11BDWLCMedicare PIN
GAF61359Medicare UPIN