Provider Demographics
NPI:1932232386
Name:BOYD, PAUL DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:BOYD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 E 33RD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4605
Mailing Address - Country:US
Mailing Address - Phone:405-340-0007
Mailing Address - Fax:405-340-0266
Practice Address - Street 1:151 E 33RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4605
Practice Address - Country:US
Practice Address - Phone:405-340-0007
Practice Address - Fax:405-340-0266
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2465111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor