Provider Demographics
NPI:1457962110
Name:MT. EATON MEDICAL GROUP
Entity Type:Organization
Organization Name:MT. EATON MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-359-5489
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:MOUNT EATON
Mailing Address - State:OH
Mailing Address - Zip Code:44659-0206
Mailing Address - Country:US
Mailing Address - Phone:330-359-5489
Mailing Address - Fax:330-359-5822
Practice Address - Street 1:15988 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MT. EATON
Practice Address - State:OH
Practice Address - Zip Code:44659
Practice Address - Country:US
Practice Address - Phone:330-359-5489
Practice Address - Fax:330-359-5822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty