Provider Demographics
NPI:1205369253
Name:IRBY, IVANIA TRINIDAD (MD)
Entity Type:Individual
Prefix:
First Name:IVANIA
Middle Name:TRINIDAD
Last Name:IRBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IVANIA
Other - Middle Name:TRINIDAD
Other - Last Name:ROMERO VANEGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:380 HOSPITAL DR
Mailing Address - Street 2:BLDG A, STE 320
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-8001
Mailing Address - Country:US
Mailing Address - Phone:478-742-5331
Mailing Address - Fax:833-355-1139
Practice Address - Street 1:380 HOSPITAL DR
Practice Address - Street 2:BLDG A, STE 430
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8001
Practice Address - Country:US
Practice Address - Phone:478-751-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA838362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry