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NPI Code Detail

MEDICARE: JESSE RANDALL BYRD MD

MEDICARE:   JESSE RANDALL BYRD  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician33000NC
2207R00000XInternal Medicine Physician33000NC

General Provider Information

NPI Number : 1518901446
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE RANDALL BYRD MD
Provider Business Mailing Address
First Line : 1614 HWY 56
Second Line :
City : CREEDMOOR
State : NC
Zip : 27522-8297
Country : US
Telephone Number : 919-575-6103
Fax Number : 919-575-6817
Provider Business Practice Location Address
First Line : 1614 HWY 56
Second Line :
City : CREEDMOOR
State : NC
Zip : 27522-8297
Country : US
Telephone Number : 919-575-6103
Fax Number : 919-575-6817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 09/11/2017

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Directions to “ JESSE RANDALL BYRD MD” Practice Location

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