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Kevin B Boyd

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NPI Number Detailed Information

Provider Information:

Name: Kevin B Boyd
Gender: M
Provider License Number If Given: 1062723

NPI Information:

NPI: 1679572184
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 11/30/2015

Provider Business Mailing Address:

Address: PO BOX 70354
Louisville, KY 40270
Phone Number: 5024732132
Fax Number: 5024590923

Provider Business Practice Location Address:

Address: 4000 KRESGE WAY
Louisville, KY 40207
Phone Number: 5024732132
Fax Number: 5024590923

Provider Taxonomy:

Primary: 163W00000X
Secondary (if any): 367500000X
State: KY

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