Individual
KENNETH BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
312 ARMSTRONG ST, ROGERSVILLE, TN 37857-3606
(855) 933-6286
(865) 217-1094
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 296-9937
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2041
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525628
—
TN
01
—
6094174
BCBS OF TN
TN
Enumeration date
09/15/2011
Last updated
05/10/2017
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