Provider Demographics
NPI:1942234380
Name:BYARS, THOMAS F (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:BYARS
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 1:575 PROFESSIONAL DR STE 550
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3356
Mailing Address - Country:US
Mailing Address - Phone:855-647-7678
Mailing Address - Fax:404-847-4488
Practice Address - Street 1:575 PROFESSIONAL DR STE 550
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3356
Practice Address - Country:US
Practice Address - Phone:855-647-7678
Practice Address - Fax:404-847-4488
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD39135207X00000X, 207RS0010X, 208000000X
GA596892080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000612598FMedicaid
62-0476822OtherTAX ID