MEDICARE: LORA A BOYD AUDIOLOGIST

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	231H00000X	Audiologist	A195	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679688584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORA A BOYD AUDIOLOGIST

Provider Business Mailing Address
First Line	:	4300 ROGERS AVE STE 15
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3152
Country	:	US
Telephone Number	:	479-785-3277
Fax Number	:	479-785-3278

Provider Business Practice Location Address
First Line	:	4300 ROGERS AVE STE 15
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3152
Country	:	US
Telephone Number	:	479-785-3277
Fax Number	:	479-785-3278

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/18/2021

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