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NPI Code Detail

MEDICARE: DR. JOSHUA BYERS O.D,

MEDICARE:  DR. JOSHUA  BYERS  O.D,
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
1152W00000XOptometrist4901004986MI
2152WP0200XPediatric Optometrist4901004986MI

General Provider Information

NPI Number : 1417499823
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA BYERS O.D,
Provider Business Mailing Address
First Line : 2603 NILES AVE
Second Line : SUITE A
City : SAINT JOSEPH
State : MI
Zip : 49085-1954
Country : US
Telephone Number : 269-408-8762
Fax Number : 269-408-8764
Provider Business Practice Location Address
First Line : 2603 NILES AVE
Second Line : SUITE A
City : SAINT JOSEPH
State : MI
Zip : 49085-1954
Country : US
Telephone Number : 269-408-8762
Fax Number : 269-408-8764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2016
Last Update Date : 11/16/2016

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Directions to “ DR. JOSHUA BYERS O.D,” Practice Location

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