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General NPI Number Information
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NPI Number | 1013809805
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Entity Type | Individual
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Provider Name | ISAIAH ANTONIO BOYD PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 226 WILLIS DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7272
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Country | US
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Telephone | 770-389-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 ETHANS WAY
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City | MCDONOUGH
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State | GA
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Zip | 30252-1710
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Country | US
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Telephone | 678-392-6350
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 13244
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License Number State | GA
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