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General NPI Number Information
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NPI Number | 1134384720
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Entity Type | Individual
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Provider Name | BRADLEY BOYD D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 3620 JOSPEH SIEWICK DR STE 201 FAIR OAKS ORTHOPAEDIC ASSOCIATES
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City | FAIRFAX
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State | VA
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Zip | 22033
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Country | US
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Telephone | 703-391-0111
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Fax | 703-391-2945
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Provider Business Mailing Address
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Address Line | 3620 JOSPEH SIEWICK DR STE 201 FAIR OAKS ORTHOPAEDIC ASSOCIATES
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City | FAIRFAX
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State | VA
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Zip | 22033
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Country | US
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Telephone | 703-391-0111
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Fax | 703-391-2945
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0102203371
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License Number State | VA
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