Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 029170 | GA |
NPI | 1013027267 |
---|---|
Provider Name | Dr. Waldo Emerson Floyd III |
First Address | Macon, GA 31208 |
Second Address | Macon, GA 31210-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 01/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000339875A | (05) | GA |
400000472 | MEDICARE RAILROAD (01) | GA |
B79476 | (02) |