Provider Demographics
NPI:1265429252
Name:BACHNER, ROBERT S (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:BACHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:505 IRVIN CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1706
Mailing Address - Country:US
Mailing Address - Phone:404-294-4111
Mailing Address - Fax:404-292-3505
Practice Address - Street 1:505 IRVIN CT
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1706
Practice Address - Country:US
Practice Address - Phone:404-294-4111
Practice Address - Fax:404-292-3505
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA36918174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00571084AMedicaid
GA00571084AMedicaid
GAF26358Medicare UPIN