Provider Demographics
NPI:1457332439
Name:BYRD, ROBERT STACY (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STACY
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27436 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-5050
Mailing Address - Country:US
Mailing Address - Phone:530-756-1716
Mailing Address - Fax:
Practice Address - Street 1:2615 STOCKTON BLVD
Practice Address - Street 2:SUITE 337
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2209
Practice Address - Country:US
Practice Address - Phone:916-734-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG084192208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics