Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 20339 | TN |
NPI | 1013084953 |
---|---|
Provider Name | Kathryn W Byrd |
First Address | Memphis, TN 38119-4823 |
Second Address | Memphis, TN 38119-4823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 18/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3075062 | (05) | TN |
F54576 | (02) |