MEDICARE: DR. MICHAEL R BYARS 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
1	152W00000X	Optometrist	OPT.003400	OH

General Provider Information

NPI Number	:	1477545382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL R BYARS O.D.

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	:	740-852-9742

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	:	740-852-9742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	04/26/2020

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