MEDICARE: WILLIAM BRADLEY BOYD MD

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	208000000X	Pediatrics Physician	68375	GA
2	207R00000X	Internal Medicine Physician	68375	GA

General Provider Information

NPI Number	:	1568419471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM BRADLEY BOYD MD

Provider Business Mailing Address
First Line	:	1485 JESSE JEWELL PKWY NE STE 200A
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3806
Country	:	US
Telephone Number	:	770-534-5255
Fax Number	:	770-287-3871

Provider Business Practice Location Address
First Line	:	1485 JESSE JEWELL PKWY NE STE 200A
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3806
Country	:	US
Telephone Number	:	770-534-5255
Fax Number	:	770-287-3871

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/30/2012

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Directions to “ WILLIAM BRADLEY BOYD MD” Practice Location

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