MEDICARE: DR. THOMAS W BYRON M.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	207XS0106X	Orthopaedic Hand Surgery Physician	MD024634E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000407060	OTHER	PA	BLUE SHIELD
2	072017	OTHER	PA	FIRST PRIORITY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659302206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS W BYRON M.D.

Provider Business Mailing Address
First Line	:	2800 MEMORIAL HWY
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-1569
Country	:	US
Telephone Number	:	570-675-7637
Fax Number	:	570-675-7882

Provider Business Practice Location Address
First Line	:	2800 MEMORIAL HWY
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-1569
Country	:	US
Telephone Number	:	570-675-7637
Fax Number	:	570-675-7882

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/16/2016

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