Provider Demographics
NPI:1578672663
Name:BYERLY, ROBERT GENE (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GENE
Last Name:BYERLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 SE OAK STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4147
Mailing Address - Country:US
Mailing Address - Phone:503-640-5950
Mailing Address - Fax:503-648-3140
Practice Address - Street 1:545 SE OAK ST
Practice Address - Street 2:SUITE F
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4147
Practice Address - Country:US
Practice Address - Phone:503-640-5950
Practice Address - Fax:503-648-3140
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMO12680207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC91230000001OtherPROVIDENCE
OR003293002OtherBLUE CROSS
OR0S2931Medicaid
ORDG4207OtherRAILROAD MEDICARE GROUP #
OR0S2931Medicaid
ORDG4207OtherRAILROAD MEDICARE GROUP #