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General NPI Number Information
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NPI Number | 1215151931
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Entity Type | Individual
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Provider Name | DWAYNE M AYERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 27823 MAIN ST
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City | MORGAN
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State | GA
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Zip | 39866-0249
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Country | US
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Telephone | 229-849-5059
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Fax | 229-849-5114
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Provider Business Mailing Address
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Address Line | 435 TURNER ST P.O. BOX 806
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City | EDISON
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State | GA
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Zip | 39846-0806
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Country | US
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Telephone | 229-835-2635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 030002
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License Number State | GA
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