MEDICARE: DR. MICHAEL R. BYARS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	3400	OH

General Provider Information

NPI Number	:	1063676088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MICHAEL R. BYARS, INC.

Provider Business Mailing Address
First Line	:	140 E HIGH ST
Second Line	:
City	:	LONDON
State	:	OH
Zip	:	43140-1260
Country	:	US
Telephone Number	:	740-852-4649
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 E HIGH ST
Second Line	:
City	:	LONDON
State	:	OH
Zip	:	43140-1260
Country	:	US
Telephone Number	:	740-852-4649
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL R. BYARS
Credential	:	O.D.
Telephone Number	:	740-852-4649

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	12/03/2008

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