Provider Demographics
NPI:1093762700
Name:ROBERT J. DAYER, M.D., PC
Entity Type:Organization
Organization Name:ROBERT J. DAYER, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-228-2535
Mailing Address - Street 1:PO BOX 1645
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1645
Mailing Address - Country:US
Mailing Address - Phone:706-228-2535
Mailing Address - Fax:706-228-3433
Practice Address - Street 1:111 N THIRD ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30428-2301
Practice Address - Country:US
Practice Address - Phone:912-523-5113
Practice Address - Fax:706-228-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E80134Medicare UPIN
GAGRP7597Medicare ID - Type Unspecified