Individual
DR. GEORGE WAYNE BYRAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1455 E BERT KOUNS INDUSTRIAL LOOP # 210, SHREVEPORT, LA 71105
(187) 984-6233
Mailing address
1455 E BERT KOUNS INDUSTRIAL LOOP # 210, SHREVEPORT, LA 71105-6000
(318) 423-4482
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
24984
MS
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD.308290
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2474294
—
LA
Enumeration date
05/09/2012
Last updated
07/18/2018
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