Healthcare Provider Details

I. General information

NPI: 1295783017
Provider Name (Legal Business Name): DANIEL F BYRD D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 SW DORION AVE
PENDLETON OR
97801-2039
US

IV. Provider business mailing address

714 SW DORION AVE
PENDLETON OR
97801-2086
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-2372
  • Fax: 541-276-2411
Mailing address:
  • Phone: 541-276-2372
  • Fax: 541-276-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberDP00295
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDP00295
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: