Provider Demographics
NPI:1356081590
Name:BOYD, TIMOTHY R (PT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:R
Last Name:BOYD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 SHERWOOD COMMON BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4870
Mailing Address - Country:US
Mailing Address - Phone:225-451-4500
Mailing Address - Fax:
Practice Address - Street 1:910 MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1838
Practice Address - Country:US
Practice Address - Phone:985-385-5172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist