Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | R8F63 | MO |
NPI | 1215928114 |
---|---|
Provider Name | James H Boyd |
First Address | Saint Louis, MO 63179-0379 |
Second Address | Saint Louis, MO 63141-8219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 06/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79156 | (02) | MO |