Provider Demographics
NPI:1497975106
Name:WINDHAM, BYRON PEARSON (MD)
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:PEARSON
Last Name:WINDHAM
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 1:497 AZALEA DR
Mailing Address - Street 2:#101
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655
Mailing Address - Country:US
Mailing Address - Phone:662-234-1337
Mailing Address - Fax:662-281-1490
Practice Address - Street 1:497 AZALEA DR
Practice Address - Street 2:#101
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-234-1337
Practice Address - Fax:662-281-1490
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19525207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology