Oliver Wayne Byrd, M.D.

Individual provider Active NPI Family Medicine Physician · Quitman, MS

NPI 1821070236 · NPPES record last updated Nov 7, 2013

Key facts

NPI
1821070236
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
06986 (MS)
Practice address
603 S Archusa Ave
Quitman, MS 39355-2331
Phone
(601) 776-2123
Fax
(601) 776-6006
NPI assigned
Nov 20, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 06986 MS Yes

Addresses

Primary practice location

603 S Archusa Ave
Quitman, MS 39355-2331

Mailing address

PO Box 5208
Meridian, MS 39302-5208
Phone (601) 703-4282

Other identifiers

IdentifierTypeStateIssuer
080185587OtherRAILROAD MEDICARE
00016364MedicaidMS
730-07884OtherBLUE CROSS OF AL

Other providers in Quitman, MS

All providers in Quitman, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.