1104801950 NPI number — JAMES W DYE M.D.

Table of content: JAMES W DYE M.D. (NPI 1104801950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104801950 NPI number — JAMES W DYE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DYE
Provider First Name:
JAMES
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DYE
Provider Other First Name:
WADE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1104801950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1213
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRUNSWICK
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31521-1213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-283-7951
Provider Business Mailing Address Fax Number:
912-285-7922

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 RIVERSIDE AVE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYCROSS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31501-7020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-809-5112
Provider Business Practice Location Address Fax Number:
912-809-5115
Provider Enumeration Date:
12/14/2005

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: 208800000X , with the licence number:  034129 , 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: 00456156A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10057862 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 300020047C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 340003981 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 339931 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 024623 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com