Provider Demographics
NPI:1598741308
Name:BYRON, CARL JAMES III
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:JAMES
Last Name:BYRON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SKYLINE ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-7818
Mailing Address - Country:US
Mailing Address - Phone:828-238-8545
Mailing Address - Fax:828-495-7873
Practice Address - Street 1:50 SKYLINE ROAD EXT
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-7818
Practice Address - Country:US
Practice Address - Phone:828-238-8545
Practice Address - Fax:828-495-7873
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer