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General NPI Number Information
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NPI Number | 1770076176
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Entity Type | Individual
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Provider Name | JEFFREY M BOYD DO
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Gender | Male
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 111 S 11TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-955-6585
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Fax | 215-955-2311
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Provider Business Mailing Address
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Address Line | 25 S 9TH ST FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4408
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Country | US
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Telephone | 215-955-6585
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Fax | 215-955-2311
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OT018240
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License Number State | PA
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