1659477131 NPI number — DR. HAL C. BYCK MD

Table of content: DR. HAL C. BYCK MD (NPI 1659477131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659477131 NPI number — DR. HAL C. BYCK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BYCK
Provider First Name:
HAL
Provider Middle Name:
C.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
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:
1659477131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NEMOURS CHILDRENS CLINIC
Provider Second Line Business Mailing Address:
P.O. BOX 404112
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-390-3610
Provider Business Mailing Address Fax Number:
904-288-5890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEMOURS PEDIATRICS JESSUP ST.
Provider Second Line Business Practice Location Address:
1602 JESSUP STREET
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19802-4210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-576-5050
Provider Business Practice Location Address Fax Number:
302-576-5065
Provider Enumeration Date:
09/15/2006

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: 208000000X , with the licence number:  C10003946 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: C10003946 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208M00000X , with the licence number: C10003946 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 5607400 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6704204 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001447101 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4423030 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1484311 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com