Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 18493 | OK |
NPI | 1023114675 |
---|---|
Provider Name | Aaron Lee Boyd |
First Address | Norman, OK 73070 |
Second Address | Norman, OK 73069-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 05/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100112960A | (05) | OK |