Healthcare Provider Details

I. General information

NPI: 1770701526
Provider Name (Legal Business Name): MICHAEL WILLIAM BOYD A.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 MAPLE AVE
BURLINGTON NC
27215-6846
US

IV. Provider business mailing address

1736 MAPLE AVE
BURLINGTON NC
27215-6846
US

V. Phone/Fax

Practice location:
  • Phone: 336-228-1403
  • Fax: 336-228-1503
Mailing address:
  • Phone: 336-228-1403
  • Fax: 336-228-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number27-3468101
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number27-3468101
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: