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General NPI Number Information
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NPI Number | 1558510453
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Entity Type | Individual
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Provider Name | LELAN CLINTON BYRD M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3633 WHEELER RD STE 365
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City | AUGUSTA
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State | GA
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Zip | 30909-6549
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Country | US
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Telephone | 706-432-6866
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 15TH ST OR 6000
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-3183
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30026
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License Number State | GA
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