Basic Information
Provider Information
NPI: 1891962031
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AYERS
FirstName: GARY
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
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Mailing Information
Address1: 1 HOSPITAL DR STE 306
Address2:  
City: LEWISBURG
State: PA
PostalCode: 178379350
CountryCode: US
TelephoneNumber: 5705224110
FaxNumber: 5707683911
Practice Location
Address1: 25 LYSTRA ROGERS DR
Address2:  
City: LEWISBURG
State: PA
PostalCode: 178378807
CountryCode: US
TelephoneNumber: 5705233290
FaxNumber: 5705245231
Other Information
ProviderEnumerationDate: 05/15/2008
LastUpdateDate: 06/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XOS014424PAY Allopathic & Osteopathic PhysiciansSurgery 
2083P0011XOS014424PAN Allopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine

No ID Information.


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