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General NPI Number Information
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NPI Number | 1447215181
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Entity Type | Individual
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Provider Name | HENRY B BYRUM JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 4003 KRESGE WAY SUITE 410
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City | LOUISVILLE
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State | KY
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Zip | 40207-4652
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Country | US
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Telephone | 502-893-7462
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Fax | 502-212-7551
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Provider Business Mailing Address
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Address Line | PO BOX 950248
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City | LOUISVILLE
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State | KY
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Zip | 40295-0248
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Country | US
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Telephone | 502-253-4900
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Fax | 502-489-5750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18003
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License Number State | KY
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