Provider Demographics
NPI:1902364383
Name:PEPPER, ROBERT THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THOMAS
Last Name:PEPPER
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 1:1740 LIONS CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-4762
Mailing Address - Country:US
Mailing Address - Phone:706-752-2284
Mailing Address - Fax:706-342-3419
Practice Address - Street 1:1740 LIONS CLUB RD STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-4762
Practice Address - Country:US
Practice Address - Phone:706-752-2373
Practice Address - Fax:706-438-1278
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine