Provider Demographics
NPI:1962446989
Name:BOYD, ALLEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:D
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 N BEAVER ST
Mailing Address - Street 2:PAYER CREDENTIALING
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3118
Mailing Address - Country:US
Mailing Address - Phone:928-773-2559
Mailing Address - Fax:928-213-6292
Practice Address - Street 1:450 S WILLARD ST
Practice Address - Street 2:SUITE 105
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6743
Practice Address - Country:US
Practice Address - Phone:928-634-1112
Practice Address - Fax:928-634-1117
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY191229207XS0114X
AZ50006207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ987180Medicaid
A15241Medicare UPIN
AZZ175069Medicare PIN