Provider Demographics
NPI:1164436861
Name:BOYCE, CLIFFORD VERNON III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:VERNON
Last Name:BOYCE
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 W FLEMING DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4450
Mailing Address - Country:US
Mailing Address - Phone:828-580-3278
Mailing Address - Fax:828-580-3279
Practice Address - Street 1:695 W FLEMING DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4450
Practice Address - Country:US
Practice Address - Phone:828-580-3278
Practice Address - Fax:828-580-3279
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02303363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1164436861Medicaid
NCNC7518BMedicare PIN
S97507Medicare UPIN