Healthcare Provider Details

I. General information

NPI: 1154326361
Provider Name (Legal Business Name): TONY L BYLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 05/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6530 LEO DR
HARRISBURG PA
17111-4852
US

IV. Provider business mailing address

6530 LEO DR
HARRISBURG PA
17111-4852
US

V. Phone/Fax

Practice location:
  • Phone: 304-482-8322
  • Fax:
Mailing address:
  • Phone: 304-482-8322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD045728L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: