Healthcare Provider Details

I. General information

NPI: 1588662522
Provider Name (Legal Business Name): ROBERT D SINYARD JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

1500 OGLETHORPE AVE SUITE 600F
ATHENS GA
30606-2179
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-1700
  • Fax: 706-475-1787
Mailing address:
  • Phone: 706-475-4917
  • Fax: 706-475-4636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number025829
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number025829
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: