Individual
SAMUEL J BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1621 WILLOW ST, VINCENNES, IN 47591-4211
(812) 882-2400
(812) 882-2422
Mailing address
PO BOX 665, VINCENNES, IN 47591-0665
(812) 882-2400
(812) 882-2422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01058714A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325459
BCBS PIN
IN
05
—
200475520
—
IN
Enumeration date
05/31/2005
Last updated
05/17/2011
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