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General NPI Number Information
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NPI Number | 1295754075
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Entity Type | Individual
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Provider Name | RODERICK RENE BOYD MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 460 W OAK ST STE 601
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City | EL DORADO
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State | AR
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Zip | 71730-4538
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Country | US
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Telephone | 870-863-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 71 WILLOW GREEN DR
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City | JACKSON
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State | TN
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Zip | 38305-9757
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Country | US
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Telephone | 870-816-5715
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 18052
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD427685
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | E-2313
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 18052
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 32355
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License Number State | OK
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