Healthcare Provider Details
I. General information
NPI: 1750380309
Provider Name (Legal Business Name): CLARENCE DEWAYNE BOYD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 07/16/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2708 7TH AVE S
BIRMINGHAM AL
35233-3406
US
IV. Provider business mailing address
8816 DEERBROOK CIR
GARDENDALE AL
35071-3237
US
V. Phone/Fax
- Phone: 205-297-0075
- Fax: 205-297-0074
- Phone: 205-647-4553
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 12389 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835N0905X |
| Taxonomy | Nuclear Pharmacist |
| License Number | 12389 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: