Individual
MR. JACK P. BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2414 CHAMBLISS AVE N.W., CLEVELAND, TN 37311
(423) 472-6581
(423) 472-2425
Mailing address
2414 CHAMBLISS AVE N.W., CLEVELAND, TN 37311
(423) 472-6581
(423) 472-2425
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD14726
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004788
—
TN
05
—
Q011340
—
TN
Enumeration date
08/30/2006
Last updated
04/20/2015
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