Provider Demographics
NPI:1508467473
Name:BOYD, JOHN WILSON JR (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILSON
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2400 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1088
Mailing Address - Country:US
Mailing Address - Phone:540-381-0882
Mailing Address - Fax:540-381-0826
Practice Address - Street 1:2400 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1088
Practice Address - Country:US
Practice Address - Phone:540-381-0882
Practice Address - Fax:540-381-0826
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist