Healthcare Provider Details

I. General information

NPI: 1194815092
Provider Name (Legal Business Name): JAMES NELSON BYRD JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

1725 SPRING HILL AVE
MOBILE AL
36604-1402
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-7289
  • Fax: 251-435-7282
Mailing address:
  • Phone: 251-435-1366
  • Fax: 251-435-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.27718
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number27718
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number27718
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: