Provider Demographics
NPI:1316986425
Name:BOYD, JASON K (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:K
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534
Mailing Address - Country:US
Mailing Address - Phone:919-580-0000
Mailing Address - Fax:919-587-9047
Practice Address - Street 1:203 COX BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534
Practice Address - Country:US
Practice Address - Phone:919-580-0000
Practice Address - Fax:919-587-9047
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239813208M00000X
NC201000588207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC010278902Medicaid
NCMC11509OtherMEDICARE PROVIDER
NC011385A75OtherMEDICARE
NC011385A75OtherMEDICARE
NC010278902Medicaid
VAC02675Medicare PIN