Healthcare Provider Details

I. General information

NPI: 1508090267
Provider Name (Legal Business Name): ABBIE R BYROM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 CEDAR LN STE 900
TULLAHOMA TN
37388-2286
US

IV. Provider business mailing address

408 SETTLERS TRCE
TULLAHOMA TN
37388-8874
US

V. Phone/Fax

Practice location:
  • Phone: 931-455-2674
  • Fax: 931-455-8983
Mailing address:
  • Phone: 608-512-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number53447
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: