Provider Demographics
NPI:1720463698
Name:BOYD, CLAYTON TYLER (OD)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:TYLER
Last Name:BOYD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 NORTHRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-2735
Mailing Address - Country:US
Mailing Address - Phone:580-338-8437
Mailing Address - Fax:580-338-8361
Practice Address - Street 1:301 NORTHRIDGE CIR
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-2735
Practice Address - Country:US
Practice Address - Phone:580-338-8437
Practice Address - Fax:580-338-8361
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2836152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist