Provider Demographics
NPI:1669752846
Name:GEARING, BOBBY CECIL III (MD, MS)
Entity type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:CECIL
Last Name:GEARING
Suffix:III
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ZEBULON RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-5117
Mailing Address - Country:US
Mailing Address - Phone:770-227-5510
Mailing Address - Fax:
Practice Address - Street 1:1900 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-5117
Practice Address - Country:US
Practice Address - Phone:770-227-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86130208D00000X
390200000X
NY263126208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003245194Medicaid