Provider Demographics
NPI:1174799738
Name:BYRON, ERIC CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:BYRON
Suffix:
Gender:M
Credentials:
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Mailing Address - Street 1:300 W HOSPITAL ROAD EISENHOWER ARMY MEDICAL CENTER
Mailing Address - Street 2:ATTN: CREDENTALS
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-2720
Mailing Address - Fax:706-787-8176
Practice Address - Street 1:300 W HOSPITAL ROAD EISENHOWER ARMY MEDICAL CENTER
Practice Address - Street 2:ATTN: CREDENTALS
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-2720
Practice Address - Fax:706-787-8176
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN