Byrd, Samuel J

Byrd, Samuel J is an individual health care provider with primary practice located at 1621 Willow St , Vincennes IN 47591-4211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Byrd, Samuel J can be contacted via phone (812) 882-2400.

Contact Information

Primary practice address
1621 Willow St Vincennes IN 47591-4211
Fax: (812) 882-2422
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01058714A Indiana

Profile Details

NPI number 1790788081
LBN Legal business name Byrd, Samuel J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated May 17th, 2011 - about 13 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 1790788081 NPPES
Indiana Other 000000325459 BCBS PIN
Indiana MEDICAID 200475520 BCBS PIN

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