Provider Demographics
NPI:1205835543
Name:BYRD, LEMUEL P JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LEMUEL
Middle Name:P
Last Name:BYRD
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 TRIANGLE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2828
Mailing Address - Country:US
Mailing Address - Phone:704-392-1338
Mailing Address - Fax:704-392-8156
Practice Address - Street 1:4016 TRIANGLE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-2828
Practice Address - Country:US
Practice Address - Phone:704-392-1338
Practice Address - Fax:704-392-8156
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890837BMedicaid
NC244423AMedicare ID - Type Unspecified
NC890837BMedicaid