Individual
DR. CHARLES R. BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2751 ALBERT L BICKNELL DR, STE. 3-D, SHREVEPORT, LA 71103-3920
(318) 221-4755
(318) 424-3642
Mailing address
2751 ALBERT L BICKNELL DR, SUITE 3-D, SHREVEPORT, LA 71103-3920
(318) 221-4755
(318) 424-3642
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CDS.005128-MD
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113361
—
LA
Enumeration date
03/21/2006
Last updated
06/21/2021
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