Dyal, Larry B

Dyal, Larry B is an individual health care provider with primary practice located at 10 Professional Dr , Brunswick GA 31520-3774. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Dyal, Larry B can be contacted via phone (912) 265-0709.

Contact Information

Primary practice address
10 Professional Dr Brunswick GA 31520-3774
Phone: (912) 265-0709
Fax: (912) 574-5953
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD000997 Georgia

Profile Details

NPI number 1871581744
LBN Legal business name Dyal, Larry B
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871581744 NPPES
Georgia MEDICAID 400885615D

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