Healthcare Provider Details

I. General information

NPI: 1912547456
Provider Name (Legal Business Name): MICHAEL J DAY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E HOSPITAL RD
FORT EISENHOWER GA
30905
US

IV. Provider business mailing address

300 E HOSPITAL RD
FORT EISENHOWER GA
30905
US

V. Phone/Fax

Practice location:
  • Phone: 706-787-5168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1183049
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: