MEDICARE: JULIE BOYD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	1036	AL

General Provider Information

NPI Number	:	1043603236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE BOYD PA-C

Provider Business Mailing Address
First Line	:	1720 2ND AVE S # FOT1060
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35233-1806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 20TH ST S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35233-2028
Country	:	US
Telephone Number	:	205-934-7170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	03/11/2015

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