Provider Demographics
NPI:1831184068
Name:BYRD, WILLIAM G (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2883 S MENDENHALL RD STE 3-4
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-1748
Mailing Address - Country:US
Mailing Address - Phone:901-347-2374
Mailing Address - Fax:901-421-5622
Practice Address - Street 1:2883 S MENDENHALL RD STE 3-4
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-1748
Practice Address - Country:US
Practice Address - Phone:901-347-2368
Practice Address - Fax:901-421-5622
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38466207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3895531Medicare ID - Type Unspecified
TNH68641Medicare UPIN