Provider Demographics
NPI:1194066035
Name:BYRD, TAMEKA DEANNE (DO)
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:DEANNE
Last Name:BYRD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4827
Mailing Address - Country:US
Mailing Address - Phone:770-228-5402
Mailing Address - Fax:770-999-2619
Practice Address - Street 1:701 BLUEBIRD BLVD
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:GA
Practice Address - Zip Code:31030-5085
Practice Address - Country:US
Practice Address - Phone:478-654-2300
Practice Address - Fax:478-654-2001
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA077354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine