Provider Demographics
NPI:1134140734
Name:BYRD, JAMES CARSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CARSON
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1807 STATION DR STE C
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5592
Mailing Address - Country:US
Mailing Address - Phone:334-491-1901
Mailing Address - Fax:334-491-1903
Practice Address - Street 1:1807 STATION DR STE C
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5592
Practice Address - Country:US
Practice Address - Phone:334-491-1901
Practice Address - Fax:334-491-1903
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00791918OtherMEDICARE RAILROAD
AL009964885Medicaid
AL051595102OtherBCBS OF AL
AL106241Medicaid
AL01-01747OtherUNITED HEALTH CARE
AL127906Medicaid
AL51116106OtherBLUE CROSS/BLUE SHIELD OF ALABAMA
AL51521501OtherBLUE CROSS AND BLUE SHEIL
P00990327OtherMEDICARE RAILROAD
AL106241Medicaid
AL01-01747OtherUNITED HEALTH CARE
102I933562Medicare PIN
AL51521501OtherBLUE CROSS AND BLUE SHEIL