1770862815

Everything you always wanted to know about BYRD J. TAEKWONDO 2 BYRD TAEKWONDO MD but were afraid to ask.

BYRD J. TAEKWONDO 2 BYRD TAEKWONDO MD

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Provider Last Name Provider Middle Name Provider First Name Provider Other Name Type Code Provider Other Last Name Provider Other First Name Provider Other Credential
BYRD J. TAEKWONDO 2 BYRD TAEKWONDO MD
Gender:
Male
Enumeration date:
2011-08-08
Last update date:
2015-12-02
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
59433752 Medicaid none CO
352217YL2G Medicare PIN none CO
P01373713 Other RAIL ROAD MEDICARE CO

Taxonomies

Taxonomy State License Number Primary?
207R00000X Internal Medicine CO DR.0053368
208M00000X Hospitalist CO DR.0053368

Phone Numbers

Type Number
Mailing Address Telephone Number 3036431159
Practice Location Address Telephone Number 3036431159
Mailing Address Fax Number 7208745886
Practice Location Address Fax Number 7208745886

Addresses

Type Address City State Postal Country
Mailing Address 11600 W 2ND PL LAKEWOOD CO 80228 CO
Practice Location Address 11600 W 2ND PL LAKEWOOD CO 80228 CO

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