Individual
EDMUND GORDON BYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
480 MARTIN LUTHER KING RD LOT B, KEYSVILLE, GA 30816-4464
(762) 994-0902
(762) 994-0907
Mailing address
2467 GOLDEN CAMP RD, AUGUSTA, GA 30906-5515
(706) 790-4440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024786
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145149011A
—
GA
Enumeration date
03/02/2006
Last updated
02/18/2021
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