Healthcare Provider Details

I. General information

NPI: 1104987031
Provider Name (Legal Business Name): HARRY S BOYD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 ALAMEDA ST
NORMAN OK
73071-5229
US

IV. Provider business mailing address

500 CHAUTAUQUA AVE
NORMAN OK
73069-5508
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-3924
  • Fax: 405-360-5100
Mailing address:
  • Phone: 405-364-3146
  • Fax: 405-364-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number45
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: