Healthcare Provider Details

I. General information

NPI: 1134163116
Provider Name (Legal Business Name): DAVID E BYBEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LIBERTY ST SUITE 400
LOUISVILLE KY
40202-1434
US

IV. Provider business mailing address

100 E LIBERTY ST SUITE 400
LOUISVILLE KY
40202-1434
US

V. Phone/Fax

Practice location:
  • Phone: 502-587-6010
  • Fax: 502-587-1314
Mailing address:
  • Phone: 502-587-6010
  • Fax: 502-587-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number16836
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: