Provider Demographics
NPI:1306806070
Name:BOYD, ROLAND LEON (DO)
Entity type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:LEON
Last Name:BOYD
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:350 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2177
Mailing Address - Country:US
Mailing Address - Phone:901-226-4003
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:2124 14TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4040
Practice Address - Country:US
Practice Address - Phone:601-553-6000
Practice Address - Fax:601-703-0124
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2024-12-09
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Provider Licenses
StateLicense IDTaxonomies
MS171952080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSF99225Medicare UPIN