Basic Information
| Provider Information | |||||||||
| NPI: | 1144251851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYLAK | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11230 | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729171230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797096700 | ||||||||
| FaxNumber: | 4797096709 | ||||||||
| Practice Location | |||||||||
| Address1: | 3501 WE KNIGHT DR | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729036248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797096700 | ||||||||
| FaxNumber: | 4797096709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 12/14/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 036-097196 | IL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | E-2235 | AR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | C52683 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 12161 | NV | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 100049900A | 05 | OK | MEDICAID | 139146001 | 05 | AR | MEDICAID | 200038813 | 01 | RR MEDICARE | OTHER |