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General NPI Number Information
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NPI Number | 1346324662
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Entity Type | Individual
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Provider Name | EILEEN BYRD DPM
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 601 OLD NORCROSS RD STE B
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4311
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Country | US
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Telephone | 770-910-9554
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Fax | 770-910-9553
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Provider Business Mailing Address
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Address Line | 1410 CHARTER OAKS LN
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3324
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Country | US
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Telephone | 678-860-9862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | POD000786
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License Number State | GA
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