Provider Demographics
NPI:1083211486
Name:BYRD, WILLIAM CODY (PA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CODY
Last Name:BYRD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:85 E HENNINGS WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3040
Mailing Address - Country:US
Mailing Address - Phone:256-453-6069
Mailing Address - Fax:
Practice Address - Street 1:15441 US HIGHWAY 17 STE 501
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-0016
Practice Address - Country:US
Practice Address - Phone:910-685-7307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9113755363A00000X
AZ8956363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant