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NPI Code Detail

MEDICARE: DR. MICHAEL WAYNE EARLY SR. M.D.

MEDICARE: DR. MICHAEL WAYNE EARLY SR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician27806GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376613570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL WAYNE EARLY SR. M.D.
Provider Business Mailing Address
First Line : 201 AVERA DR
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-5008
Country : US
Telephone Number : 478-825-3317
Fax Number : 478-825-5499
Provider Business Practice Location Address
First Line : 201 AVERA DR
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-5008
Country : US
Telephone Number : 478-825-3317
Fax Number : 478-825-5499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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