Provider Demographics
NPI:1245296151
Name:BYERLY, AMY M (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:BYERLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4420 DIXIE HWY STE 114
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2986
Practice Address - Country:US
Practice Address - Phone:502-449-6464
Practice Address - Fax:502-449-6465
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY32118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000023036IOtherHUMANA- NORTON MEDICAL ASSOCIATES
KY64321185Medicaid
KY9142574OtherCIGNA- NMA
KYP00893041OtherRAILROAD MEDICARE- NMA
KY104222OtherSIHO- NORTON MEDICAL ASSOCIATES
KY000000350522OtherANTHEM- NORTON MEDICAL ASSOCIATES
KY50023871OtherPASSPORT- NMA
KY3713268000OtherPASSPORT ADVANTAGE- NMA
KY00533128OtherMEDICARE- NORTON MEDICAL ASSOCIATES
KY00533128OtherMEDICARE KY- NORTON MEDICAL ASSOCIATES
KY50023871OtherPASSPORT- NMA
1277811Medicare PIN
KYP00893041OtherRAILROAD MEDICARE- NMA