Provider Demographics
NPI:1336124833
Name:BYRD, ALAN L (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:L
Last Name:BYRD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8313 S NC 55 HWY
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-9543
Mailing Address - Country:US
Mailing Address - Phone:919-639-2020
Mailing Address - Fax:919-639-8508
Practice Address - Street 1:8313 S NC 55 HWY
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-9543
Practice Address - Country:US
Practice Address - Phone:919-639-2020
Practice Address - Fax:919-639-8508
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890922CMedicaid
NCP00236935OtherRAILROAD MEDICARE
NC0922COtherBLUE CROSS BLUE SHIELD
NC410049545OtherRAILROAD MEDICARE
NCP00221983OtherRAILROAD MEDICARE
NC0936EOtherBLUE CROSS BLUE SHIELD
NCU58181Medicare UPIN
NC890922CMedicaid
NCP00236935OtherRAILROAD MEDICARE
NC2469766EMedicare ID - Type Unspecified