Provider Demographics
NPI:1790049658
Name:BOYD, LOUISE SUTTON (MD)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:SUTTON
Last Name:BOYD
Suffix:
Gender:F
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:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-5098
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:721 CHESTERFIELD HWY
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-7002
Practice Address - Country:US
Practice Address - Phone:843-921-1211
Practice Address - Fax:843-921-1213
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARTP005553207V00000X
SC40418207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology