Provider Demographics
NPI:1467640045
Name:KATHRYN BYRD,MD,PC.
Entity Type:Organization
Organization Name:KATHRYN BYRD,MD,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-681-9600
Mailing Address - Street 1:6401 POPLAR AVE
Mailing Address - Street 2:SUITE 324
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4823
Mailing Address - Country:US
Mailing Address - Phone:901-681-9600
Mailing Address - Fax:901-681-9608
Practice Address - Street 1:6401 POPLAR AVE
Practice Address - Street 2:SUITE 324
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4823
Practice Address - Country:US
Practice Address - Phone:901-681-9600
Practice Address - Fax:901-681-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20339261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3075062Medicaid
F54576OtherUPIN
F54576OtherUPIN