Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 053342 | GA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 053342 | GA |
NPI | 1083649073 |
---|---|
Provider Name | Jayson Alan Mcmath |
First Address | Newnan, GA 30265-5631 |
Second Address | Newnan, GA 30265-5631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 23/05/2013 |