Provider Demographics
NPI:1932437688
Name:BYRD, RICHARD L JR (MED)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:BYRD
Suffix:JR
Gender:M
Credentials:MED
Other - Prefix:MR
Other - First Name:RICK
Other - Middle Name:L
Other - Last Name:BYRD
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:508 UNGER TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-9420
Mailing Address - Country:US
Mailing Address - Phone:870-405-1133
Mailing Address - Fax:877-534-3267
Practice Address - Street 1:3120 S HAZEL ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5740
Practice Address - Country:US
Practice Address - Phone:870-405-1133
Practice Address - Fax:877-534-3267
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator