Jeffrey B Byland, O.D.
Individual provider Active NPI Optometrist · Fremont, MI
NPI 1487655643 · NPPES record last updated Dec 19, 2020
Key facts
- NPI
- 1487655643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901002849 (MI)
- Practice address
- 103 S Division Ave
PO Box E
Fremont, MI 49412-1602 - Phone
- (231) 924-4110
- Fax
- (231) 924-5007
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002849 | MI | Yes |
Addresses
Primary practice location
103 S Division Ave
PO Box E
Fremont, MI 49412-1602
Mailing address
103 S Division Ave
PO Box E
Fremont, MI 49412-1602
Phone (231) 924-4110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2892598 | Medicaid | MI | |
| 410014405 | Other | MI | MEDICARE RAILROAD |
| 900F26506 | Other | MI | BC BS OF MI |
Other providers in Fremont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.