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Individual

ROBERT TYSON DEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824
Mailing address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
052914
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
661528293A
GA
05
661528293B
GA
05
G52914
SC
01
P00331675
MEDICARE RAILROAD
GA
Enumeration date
08/31/2006
Last updated
08/03/2010
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