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General NPI Number Information
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NPI Number | 1992950059
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Entity Type | Organization
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Legal Business Name | EDGAR M. BOYD, JR. M.D. PC
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 101 ROCKEFELLER DR STE 203
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City | MUSKOGEE
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State | OK
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Zip | 74401-5050
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Country | US
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Telephone | 918-682-4580
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Fax | 918-681-4566
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Provider Business Mailing Address
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Address Line | 101 ROCKEFELLER DR STE 203
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City | MUSKOGEE
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State | OK
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Zip | 74401
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Country | US
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Telephone | 918-682-4580
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Fax | 918-681-4566
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. EDGAR MORRIS BOYD JR.
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Credential | M.D.
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Telephone | 918-682-4580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 18352
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License Number State | OK
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