Provider Demographics
NPI:1063405769
Name:BOYD, BILLY JOE III (PHD)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:JOE
Last Name:BOYD
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E. MAIN
Mailing Address - Street 2:RESOURCE MANAGEMENT
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:1300 HOPPE BLVD OUTPATIENT SERVICES-ADA
Practice Address - Street 2:SUITE 6 STRONG FAMILY DEVELOPMENT
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820
Practice Address - Country:US
Practice Address - Phone:580-436-1222
Practice Address - Fax:580-436-1333
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK992103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical