Provider Demographics
NPI:1578881488
Name:BYRD, JARON FREDRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:JARON
Middle Name:FREDRICK
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 1:6401 S HAZEL ST APT 515
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7848
Mailing Address - Country:US
Mailing Address - Phone:432-352-3212
Mailing Address - Fax:
Practice Address - Street 1:6401 S HAZEL ST APT 515
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7848
Practice Address - Country:US
Practice Address - Phone:432-352-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine