Healthcare Provider Details

I. General information

NPI: 1043603236
Provider Name (Legal Business Name): JULIE BOYD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 20TH ST S
BIRMINGHAM AL
35233-2028
US

IV. Provider business mailing address

1720 2ND AVE S # FOT1060
BIRMINGHAM AL
35233-1806
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-7170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1036
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: