Provider Demographics
NPI:1508851833
Name:BYRD, EDWIN H JR (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:H
Last Name:BYRD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:8001 YOUREE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2302
Mailing Address - Country:US
Mailing Address - Phone:318-212-3800
Mailing Address - Fax:318-212-3945
Practice Address - Street 1:8001 YOUREE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2302
Practice Address - Country:US
Practice Address - Phone:318-212-3800
Practice Address - Fax:318-212-3945
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2021-06-21
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Provider Licenses
StateLicense IDTaxonomies
LA009764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1115461Medicaid
LA1115461Medicaid
B62630Medicare UPIN