Provider Demographics
NPI:1922072438
Name:BYRD, MARK E (RPH)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:BYRD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MEADOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-6819
Mailing Address - Country:US
Mailing Address - Phone:423-569-5077
Mailing Address - Fax:423-569-7801
Practice Address - Street 1:205 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2710
Practice Address - Country:US
Practice Address - Phone:423-569-7800
Practice Address - Fax:423-569-7801
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist