| Doctor Name: | MR. ROBERT JAY MUTERSPAUGH |
| NPI Number: | 1124020425 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 003261 |
| Business Practice Address: | 802 18th St E Tifton, GA - 317943661 |
| Business Phone Number: | 2293869333 |
| Business Fax Number: | 2293861666 |
| Mailing Address: | 2400 Bellevue Rd, Suite 21-a DUBLIN |
| State: | GA |
| Postal Code: | 310212885 |
| Phone Number: | 4782757202 |
| Fax Number: | 4782748418 |
| NPI Enumeration Date: | 06/01/2005 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 003261 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |