Provider Demographics
NPI:1306886668
Name:BYATT, JAMES SYDNEY (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SYDNEY
Last Name:BYATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VAN BUREN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-1534
Mailing Address - Country:US
Mailing Address - Phone:419-436-1035
Mailing Address - Fax:419-436-0765
Practice Address - Street 1:501 VAN BUREN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-1534
Practice Address - Country:US
Practice Address - Phone:419-436-1035
Practice Address - Fax:419-436-0765
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2595599Medicaid
OHBY4172692OtherMEDICAARE
OHP00390386OtherRRMC
OHP00390386OtherRRMC
OH2595599Medicaid