Provider Demographics
NPI:1225123557
Name:BOYD, ROBERT LEE JR
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS CHAFEE (DDG 90)
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96662-1305
Mailing Address - Country:US
Mailing Address - Phone:808-474-9889
Mailing Address - Fax:
Practice Address - Street 1:USS CHAFEE (DDG 90)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96662-1305
Practice Address - Country:US
Practice Address - Phone:808-474-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman