Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 02003050A | IN |
N | 207X00000X | Orthopaedic Surgeon | 20A8775 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 02003050A | IN |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 20A8775 | CA |
NPI | 1538107818 |
---|---|
Provider Name | Michael B Boyd |
First Address | Evansville, IN 47715-8198 |
Second Address | Evansville, IN 47715-8198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 14/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200829840 | (05) | IN |
I34804 | (02) |