MEDICARE: EDWIN H BYRD JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	009764	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508851833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN H BYRD JR. MD

Provider Business Mailing Address
First Line	:	8001 YOUREE DR
Second Line	:	SUITE 300
City	:	SHREVEPORT
State	:	LA
Zip	:	71115-2302
Country	:	US
Telephone Number	:	318-212-3800
Fax Number	:	318-212-3945

Provider Business Practice Location Address
First Line	:	8001 YOUREE DR
Second Line	:	SUITE 300
City	:	SHREVEPORT
State	:	LA
Zip	:	71115-2302
Country	:	US
Telephone Number	:	318-212-3800
Fax Number	:	318-212-3945

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	06/21/2021

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