Provider Demographics
NPI:1598062168
Name:BOYD, DONALD L (M D)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:BOYD
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BEACH WALKER RD
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA
Mailing Address - State:FL
Mailing Address - Zip Code:32034-6600
Mailing Address - Country:US
Mailing Address - Phone:904-432-8111
Mailing Address - Fax:
Practice Address - Street 1:30 BEACH WALKER RD
Practice Address - Street 2:
Practice Address - City:FERNANDINA
Practice Address - State:FL
Practice Address - Zip Code:32034-6600
Practice Address - Country:US
Practice Address - Phone:904-432-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10484207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery