MEDICARE: RICHARD A BYRD 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	207L00000X	Anesthesiology Physician	9933	NV
2	207L00000X	Anesthesiology Physician	45275	AZ
3	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	9933	NV

General Provider Information

NPI Number	:	1629054291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A BYRD MD

Provider Business Mailing Address
First Line	:	RICHARD BYRD MD
Second Line	:	PO BOX 93358
City	:	LAS VEGAS
State	:	NV
Zip	:	89193
Country	:	US
Telephone Number	:	702-487-6510
Fax Number	:	702-946-1354

Provider Business Practice Location Address
First Line	:	6402 MCLEOD DR
Second Line	:	SUITE 2
City	:	LAS VEGAS
State	:	NV
Zip	:	89120
Country	:	US
Telephone Number	:	702-487-6510
Fax Number	:	702-946-1354

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	01/31/2024

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