1588662522 NPI number — DR. ROBERT D SINYARD JR. MD

Table of content: DR. ROBERT D SINYARD JR. MD (NPI 1588662522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588662522 NPI number — DR. ROBERT D SINYARD JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINYARD
Provider First Name:
ROBERT
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588662522
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 OGLETHORPE AVE
Provider Second Line Business Mailing Address:
SUITE 600F
Provider Business Mailing Address City Name:
ATHENS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30606-2179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-475-4917
Provider Business Mailing Address Fax Number:
706-475-4636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1199 PRINCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606-2797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-475-1700
Provider Business Practice Location Address Fax Number:
706-475-1787
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X , with the licence number:  025829 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 025829 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000365109F , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000365109I , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000365109J , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000365109G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00365109A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5151023 . This is a "AETNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000365109E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000365109K , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000365109L , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1265563 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 0238482 . This is a "BLUE SHEILD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 060014203 . This is a "RAILRAOD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000365109H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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