Provider Demographics
NPI:1346317146
Name:ANDREW J HURAYT MD PC
Entity Type:Organization
Organization Name:ANDREW J HURAYT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HURAYT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-261-0510
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31521-0918
Mailing Address - Country:US
Mailing Address - Phone:912-261-0510
Mailing Address - Fax:912-261-0593
Practice Address - Street 1:1421 LEE ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-7132
Practice Address - Country:US
Practice Address - Phone:912-261-0510
Practice Address - Fax:912-261-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0151962084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D45721Medicare UPIN
GA26BDFZSMedicare ID - Type Unspecified