MEDICARE: AMY RENEE BOYD P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	102932	NC

General Provider Information

NPI Number	:	1558363754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY RENEE BOYD P.A.-C

Provider Business Mailing Address
First Line	:	250 W KINGS HWY
Second Line	:
City	:	EDEN
State	:	NC
Zip	:	27288-5010
Country	:	US
Telephone Number	:	336-623-5171
Fax Number	:	336-627-5747

Provider Business Practice Location Address
First Line	:	723 S VAN BUREN RD STE B
Second Line	:
City	:	EDEN
State	:	NC
Zip	:	27288-5418
Country	:	US
Telephone Number	:	336-623-5171
Fax Number	:	336-627-5747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/04/2024

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