Provider Demographics
NPI:1437199155
Name:BYRD, RICHARD LINDSEY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LINDSEY
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-767-1156
Mailing Address - Fax:225-767-5980
Practice Address - Street 1:7777 HENNESSY BLVD STE 507
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4366
Practice Address - Country:US
Practice Address - Phone:225-767-1156
Practice Address - Fax:225-767-5980
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016317174400000X
LAMD.016317208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09832942Medicaid
LA1381900Medicaid
LAB65271Medicare UPIN
LA54481DD21Medicare PIN
LA54481Medicare PIN
LA1381900Medicaid
MS09832942Medicaid