Byrd, Jack P.

Byrd, Jack P. is an individual health care provider with primary practice located at 2414 Chambliss Ave N.W. , Cleveland TN 37311. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Byrd, Jack P. can be contacted via phone (423) 472-6581.

Contact Information

Primary practice address
2414 Chambliss Ave N.W. Cleveland TN 37311
Phone: (423) 472-6581
Fax: (423) 472-2425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X MD14726 Tennessee

Profile Details

NPI number 1144330606
LBN Legal business name Byrd, Jack P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Apr 20th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144330606 NPPES
Tennessee MEDICAID 3004788
Tennessee MEDICAID Q011340

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