Healthcare Provider Details

I. General information

NPI: 1851828735
Provider Name (Legal Business Name): BRUCE MORGAN BYRD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 BASS RD
MACON GA
31210-7557
US

IV. Provider business mailing address

1501 BASS RD
MACON GA
31210-7557
US

V. Phone/Fax

Practice location:
  • Phone: 470-200-5710
  • Fax: 770-953-6972
Mailing address:
  • Phone: 478-200-5710
  • Fax: 770-953-6972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number113040
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: