Provider Demographics
NPI:1851831234
Name:BOYD, MARLEA J (PA-C)
Entity Type:Individual
Prefix:
First Name:MARLEA
Middle Name:J
Last Name:BOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 27892
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2030
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:1325 EASTMORELAND AVE STE 310
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7544
Practice Address - Country:US
Practice Address - Phone:901-758-7970
Practice Address - Fax:901-266-6425
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2021-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN4046363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical