Provider Demographics
NPI:1063676088
Name:DR. MICHAEL R. BYARS, INC.
Entity type:Organization
Organization Name:DR. MICHAEL R. BYARS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BYARS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-852-4649
Mailing Address - Street 1:140 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1260
Mailing Address - Country:US
Mailing Address - Phone:740-852-4649
Mailing Address - Fax:
Practice Address - Street 1:140 E HIGH ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1260
Practice Address - Country:US
Practice Address - Phone:740-852-4649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3400332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBY-048961Medicare PIN
OH0476180001Medicare NSC
OHT-47232Medicare UPIN