Basic Information
Provider Information
NPI: 1003008236
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALER
FirstName: BYRON
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 W HOSPITAL RD
Address2: DEPT. OF GENERAL SURGERY
City: FORT GORDON
State: GA
PostalCode: 309055650
CountryCode: US
TelephoneNumber: 7067871153
FaxNumber:  
Practice Location
Address1: 300 W HOSPITAL RD
Address2: DEPT. OF GENERAL SURGERY
City: FORT GORDON
State: GA
PostalCode: 309055650
CountryCode: US
TelephoneNumber: 7067871153
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/12/2007
LastUpdateDate: 10/09/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X065541GAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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