Provider Demographics
NPI:1750592515
Name:BYRD, GARY STEPHEN (BCHIS)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:STEPHEN
Last Name:BYRD
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CALHOUN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-2028
Mailing Address - Country:US
Mailing Address - Phone:864-223-1178
Mailing Address - Fax:864-223-1178
Practice Address - Street 1:310 CALHOUN AVE STE A
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-2028
Practice Address - Country:US
Practice Address - Phone:864-223-1178
Practice Address - Fax:864-223-1178
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC167237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist