Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 065541 | GA |
Y | 208600000X | Surgeon | 065541 | GA |
NPI | 1003008236 |
---|---|
Provider Name | Dr. Byron James Faler |
First Address | Fort Gordon, GA 30905-5650 |
Second Address | Fort Gordon, GA 30905-5650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2007 |
Last Update Date | 09/10/2013 |