Thomas Raymond Byrnes Jr., DO
Individual provider Active NPI Family Medicine Physician · Fort Stewart, GA
NPI 1861477598 · NPPES record last updated Sep 13, 2010
Key facts
- NPI
- 1861477598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 042536 (GA)
- Practice address
- 1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5611 - Phone
- (912) 435-5820
- NPI assigned
- Dec 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160512001504 | GA | Order and Referring Only - Family Practice |
0749186039 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Pediatric Specialists LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 042536 | GA | Yes |
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 042536 | GA |
Addresses
Primary practice location
1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5611
Mailing address
1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5611
Phone (912) 435-5820
Other providers in Fort Stewart, GA
- Cole Burr
- William Patrick Burran
- Sherri Bush
- Bethany E Butler Prater
- Lori Byrd
- David Cabrera
- John Edward Cadena II
- Jacqueline Kelly Caldwell
- Millie Calhoun
- Valarie Camak-Isaac
All providers in Fort Stewart, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.