Healthcare Provider Details

I. General information

NPI: 1154486124
Provider Name (Legal Business Name): EDWYN LEE BOYD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 06/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 DATA PARK
HOOVER AL
35244-1203
US

IV. Provider business mailing address

2116 DATA PARK
HOOVER AL
35244-1203
US

V. Phone/Fax

Practice location:
  • Phone: 205-733-9595
  • Fax: 205-733-9599
Mailing address:
  • Phone: 205-733-9595
  • Fax: 205-733-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number10241
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number10241
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: