Provider Demographics
NPI:1396745584
Name:BOYD, JIMMY L JR (PA)
Entity type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:L
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:8096 TWIN BEECH RD STE 250
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7194
Mailing Address - Country:US
Mailing Address - Phone:251-279-6520
Mailing Address - Fax:251-279-6523
Practice Address - Street 1:8096 TWIN BEECH RD STE 250
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532
Practice Address - Country:US
Practice Address - Phone:251-279-6520
Practice Address - Fax:251-279-6523
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALPA211363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-114059OtherBCBS OF AL
ALP00967735OtherRR MEDICARE
AL511-114059OtherBCBS OF AL
ALS98893Medicare UPIN