Provider Demographics
NPI:1386825651
Name:BYRD MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:BYRD MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:864-486-0750
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:REIDVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29375-0159
Mailing Address - Country:US
Mailing Address - Phone:864-486-0760
Mailing Address - Fax:864-486-0761
Practice Address - Street 1:7280 C REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388
Practice Address - Country:US
Practice Address - Phone:864-486-0760
Practice Address - Fax:864-486-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care