Provider Demographics
NPI:1750578274
Name:T. JOEL BYARS, O.D.,P.C.
Entity type:Organization
Organization Name:T. JOEL BYARS, O.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:BYARS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-961-4967
Mailing Address - Street 1:5916 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-1103
Mailing Address - Country:US
Mailing Address - Phone:770-961-4967
Mailing Address - Fax:
Practice Address - Street 1:5916 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1103
Practice Address - Country:US
Practice Address - Phone:770-961-4967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0648152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00003451BMedicaid
GAGRP2367Medicare PIN
GA0162430001Medicare NSC
U22217Medicare UPIN