Provider Demographics
NPI:1467563320
Name:BYERS, TIMOTHY ROBERT (PA-C)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:BYERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E MEYER BLVD BLDG 2
Mailing Address - Street 2:SUITE 382
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1105
Mailing Address - Country:US
Mailing Address - Phone:816-523-7088
Mailing Address - Fax:855-412-7268
Practice Address - Street 1:2340 E MEYER BLVD BLDG 2
Practice Address - Street 2:SUITE 382
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1105
Practice Address - Country:US
Practice Address - Phone:816-523-7088
Practice Address - Fax:855-412-7268
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015032407363A00000X
CAPA13820363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS26167Medicare UPIN