Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 037768 | GA |
NPI | 1003824657 |
---|---|
Provider Name | Dr. John J Byrne |
First Address | Atlanta, GA 30342-5000 |
Second Address | Atlanta, GA 30342-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 24/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00591324A | (05) | GA |
F07433 | (02) | GA |