MEDICARE: DR. JACQUES R PYE MD

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
1	207P00000X	Emergency Medicine Physician	026919	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1770524134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUES R PYE MD

Provider Business Mailing Address
First Line	:	2619 DOZIER RD
Second Line	:
City	:	APPLING
State	:	GA
Zip	:	30802-1802
Country	:	US
Telephone Number	:	706-832-4344
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W HOSPITAL RD, EISENHOWER ARMY MEDICAL CENTER
Second Line	:	ATTN CREDENTIALS
City	:	FORT GORDON
State	:	GA
Zip	:	30905-5650
Country	:	US
Telephone Number	:	706-787-2264
Fax Number	:	706-787-8176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/29/2016

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