Basic Information
| Provider Information | |||||||||
| NPI: | 1467563320 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYERS | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2340 E MEYER BLVD BLDG 2 | ||||||||
| Address2: | SUITE 382 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641321105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165237088 | ||||||||
| FaxNumber: | 8554127268 | ||||||||
| Practice Location | |||||||||
| Address1: | 2340 E MEYER BLVD BLDG 2 | ||||||||
| Address2: | SUITE 382 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641321105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165237088 | ||||||||
| FaxNumber: | 8554127268 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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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 | 363A00000X | 2015032407 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA13820 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.