Healthcare Provider Details

I. General information

NPI: 1790772929
Provider Name (Legal Business Name): STEVEN THOMAS BOYD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 BIENVILLE ST
NATCHITOCHES LA
71457-5702
US

IV. Provider business mailing address

135 BEECHWOOD LN
NATCHITOCHES LA
71457-6438
US

V. Phone/Fax

Practice location:
  • Phone: 318-352-0063
  • Fax:
Mailing address:
  • Phone: 318-471-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number11497
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: