Individual
HENRY B BYRUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY, SUITE 410, LOUISVILLE, KY 40207-4652
(502) 893-7462
(502) 212-7551
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-4900
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18003
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350638
ANTHEM / NMA
—
01
—
000052155K
HUMANA / NMA
—
01
—
017043
SIHO / NMA
—
01
—
1170395
PASSPORT / NMA
—
01
—
11853
CHA / NMA
—
01
—
1452384003
CIGNA / NMA
—
05
—
200107110
—
IN
01
—
2440629000
PASSPORT ADVANTAGE / NMA
—
05
—
64810039
—
KY
01
—
P00212765
RAILROAD MEDICARE
KY
Enumeration date
04/18/2006
Last updated
07/13/2016
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