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NPI Code Detail

MEDICARE: DELILAH BYRON IDMT

MEDICARE: DELILAH BYRON IDMT
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
11710I1003XIndependent Duty Medical Technicians
2174400000XSpecialist

General Provider Information

NPI Number : 1356767404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELILAH BYRON IDMT
Provider Business Mailing Address
First Line : 4353 SANDY SPRINGS DR
Second Line :
City : VALDOSTA
State : GA
Zip : 31605-5492
Country : US
Telephone Number : 478-454-8093
Fax Number :
Provider Business Practice Location Address
First Line : 4353 SANDY SPRINGS DR
Second Line :
City : VALDOSTA
State : GA
Zip : 31605-5492
Country : US
Telephone Number : 478-454-8093
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2014
Last Update Date : 03/13/2014

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Directions to “ DELILAH BYRON IDMT” Practice Location

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