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General NPI Number Information
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NPI Number | 1194057562
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Entity Type | Individual
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Provider Name | MR. ROBERT W BAYSDON
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Gender | Male
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 2818 W BROAD ST
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-0000
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Country | US
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Telephone | 910-247-6100
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Fax | 910-247-6106
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Provider Business Mailing Address
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Address Line | PO BOX 3576
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City | LUMBERTON
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State | NC
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Zip | 28359-3576
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Country | US
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Telephone | 910-865-9000
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Fax | 910-865-9004
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Authorized Official
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Title or Position |
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Name |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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