Mark Byron MD PC
Clinic/Center, Medical Specialty in Jesup, GA. Organization (NPI-2).
NPI number1063607828
StatusActive
Last updated in NPPESJan 26, 2011
Details
- NPI
- 1063607828
- Entity type
- Organization (NPI-2)
- Legal business name
- Mark Byron MD PC
- Organization subpart
- Yes
- Enumeration date
- Sep 13, 2007
- Last updated
- Jan 26, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | 047579 | GA | Yes |
Other names
- Wayne Urology (Other Name)
Practice location
162 Memorial DrJesup, GA 31545-0101
Phone 912-427-8033
Mailing address
162 Memorial DrJesup, GA 31545-0101
Phone 912-427-8033 · Fax 912-427-7565
Authorized official
Mark Daniel Byron
MD Owner
9124278033
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