Provider Demographics
NPI:1497998967
Name:BOYD, ZACHARY (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 W 110TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1545
Mailing Address - Country:US
Mailing Address - Phone:913-319-8400
Mailing Address - Fax:913-696-0040
Practice Address - Street 1:6650 W 110TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1544
Practice Address - Country:US
Practice Address - Phone:913-491-9299
Practice Address - Fax:913-491-3089
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130274362085R0202X, 174400000X
KS0436548390200000X
KS04-36548390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO323A00003OtherMEDICARE PTAN