Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | DR.0065582 | CO |
NPI | 1053765396 |
---|---|
Provider Name | Christopher Jordan Boyd |
First Address | Charlottesville, VA 22903-2141 |
Second Address | Kansas City, KS 66160-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2016 |
Last Update Date | 21/05/2021 |