Byerly, Kenneth
Byerly, Kenneth is an individual health care provider with primary practice located at 3630 Guion Rd , Indianapolis IN 46222-1616. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Emergency Medical Technician, Paramedic, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Byerly, Kenneth can be contacted via phone (317) 920-7195.Contact Information
Primary practice address
3630 Guion Rd
Indianapolis IN 46222-1616
Phone: (317) 920-7195
Fax: (317) 920-7551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Emergency Medical Service Providers / Emergency Medical Technician, Paramedic | 146L00000X | 02001355 | Indiana |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 02001355 | Indiana |
Profile Details
| NPI number | 1023016607 |
|---|---|
| LBN Legal business name | Byerly, Kenneth |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Aug 14th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023016607 | NPPES |
| Indiana | Other | 000000191757 | ANTHEM BLUE CROSS PROV. # |
| Indiana | MEDICAID | 100270690A | ANTHEM BLUE CROSS PROV. # |
| Indiana | Other | 02001355 | ANTHEM BLUE CROSS PROV. # |
| Indiana | MEDICAID | 100386410 | ANTHEM BLUE CROSS PROV. # |
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