Provider Demographics
NPI:1073616629
Name:BYRD, REBECCA R (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:BYRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 GRANDVIEW PKWY STE 820
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3408
Mailing Address - Country:US
Mailing Address - Phone:205-971-3000
Mailing Address - Fax:
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 820
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3408
Practice Address - Country:US
Practice Address - Phone:205-971-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20210207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009995555Medicaid
AL009995555Medicaid
G60314Medicare UPIN