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General NPI Number Information
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NPI Number | 1578833422
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Entity Type | Organization
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Legal Business Name | GLENN H BOYD MD PC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 1203 MEMORIAL DRIVE
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City | DALTON
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State | GA
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Zip | 30720-2530
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Country | US
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Telephone | 706-278-0022
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Fax | 706-278-6360
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Provider Business Mailing Address
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Address Line | 1203 MEMORIAL DR
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City | DALTON
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State | GA
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Zip | 30720-2571
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Country | US
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Telephone | 706-278-0022
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Fax | 706-278-6360
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GLENN H BOYD
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Credential | M.D.
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Telephone | 706-278-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17510
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License Number State | GA
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