MEDICARE: JAMES H BOYD M.D.

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	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	R8F63	MO

General Provider Information

NPI Number	:	1215928114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES H BOYD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 790379
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63179-0379
Country	:	US
Telephone Number	:	314-251-6394
Fax Number	:	314-251-4235

Provider Business Practice Location Address
First Line	:	607 S NEW BALLAS RD
Second Line	:	STE 2300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8219
Country	:	US
Telephone Number	:	314-251-6394
Fax Number	:	314-251-4235

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	02/06/2017

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