Provider Demographics
NPI:1528195674
Name:BAYER, GARY C (PHD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:C
Last Name:BAYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 12TH ST
Mailing Address - Street 2:STE 803
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2462
Mailing Address - Country:US
Mailing Address - Phone:706-577-7546
Mailing Address - Fax:706-341-0008
Practice Address - Street 1:233 12TH ST STE 803
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2462
Practice Address - Country:US
Practice Address - Phone:706-577-7546
Practice Address - Fax:706-577-7546
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000827103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861990202OtherNPI