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General NPI Number Information
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NPI Number | 1306289608
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Entity Type | Individual
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Provider Name | DUSTY JAMES BOYD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 223 E JACKSON AVE
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City | JONESBORO
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State | AR
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Zip | 72401-3119
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Country | US
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Telephone | 870-972-0063
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Fax |
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Provider Business Mailing Address
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Address Line | 220 MILLER RD
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City | HUNTINGDON
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State | TN
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Zip | 38344-8450
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E9222
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License Number State | AR
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