Individual
DR. KENNETH BYERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3630 GUION RD, INDIANAPOLIS, IN 46222-1616
(317) 920-7195
(317) 920-7551
Mailing address
3630 GUION RD, INDIANAPOLIS, IN 46222-1616
(317) 920-7195
(317) 920-7551
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
02001355
IN
207P00000X
Emergency Medicine Physician
Primary
02001355
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191757
ANTHEM BLUE CROSS PROV. #
IN
01
—
02001355
STATE LICENSE NUMBER
IN
05
—
100270690A
—
IN
05
—
100386410
—
IN
05
—
2867358
—
OH
Enumeration date
07/08/2005
Last updated
08/07/2024
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