1518911734 NPI number — DR. JAMES F BOYD MD

Table of content: DR. JAMES F BOYD MD (NPI 1518911734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518911734 NPI number — DR. JAMES F BOYD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOYD
Provider First Name:
JAMES
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518911734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6350 CENTER DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-4107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-213-5700
Provider Business Mailing Address Fax Number:
757-213-5762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1503B N ROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909-3243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-331-2204
Provider Business Practice Location Address Fax Number:
523-311-9092
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X , with the licence number:  0101274173 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 29078 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3643669 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1592059006 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8917261 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 17261 . This is a "BCBSNC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: AETNA . This is a "2291322" identifier . This identifiers is of the category "OTHER".




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