Provider Demographics
NPI:1093270803
Name:SMITH, BOYD SETH (PA-C)
Entity type:Individual
Prefix:
First Name:BOYD
Middle Name:SETH
Last Name:SMITH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 REIDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-5643
Mailing Address - Country:US
Mailing Address - Phone:864-576-9201
Mailing Address - Fax:864-576-6584
Practice Address - Street 1:3021 REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5643
Practice Address - Country:US
Practice Address - Phone:864-576-9201
Practice Address - Fax:864-576-6584
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
SC3144363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty