Charles R. Byrd MD A Professional
Specialist in Shreveport, LA. Organization (NPI-2).
NPI number1124042585
StatusActive
Last updated in NPPESAug 26, 2011
Details
- NPI
- 1124042585
- Entity type
- Organization (NPI-2)
- Legal business name
- Charles R. Byrd MD A Professional
- Organization subpart
- No
- Enumeration date
- Jul 27, 2006
- Last updated
- Aug 26, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
2751 Albert L Bicknell DrSte 3-D
Shreveport, LA 71103-3920
Phone 318-221-4755 · Fax 318-424-3642
Mailing address
2751 Albert L Bicknell DrSte 3-D
Shreveport, LA 71103-3920
Phone 318-221-4755 · Fax 318-424-3642
Authorized official
Kathy Hawthorne
Lpn
3182214755
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