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General NPI Number Information
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NPI Number | 1487664900
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Entity Type | Individual
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Provider Name | JOHN THOMAS BOYD MD
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9040 REID ST FT LEWIS MAMC
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-968-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 2037 MINOR AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-3513
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Country | US
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Telephone | 206-860-9321
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Fax | 253-968-5573
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 00018810
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License Number State | WA
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