| Boyd Family Practice Llc | |
|
1518 Doctors Dr Bossier City LA 71111-3322 | |
| (318) 746-1094 | |
| (318) 746-2808 |
| Full Name | Boyd Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1518 Doctors Dr, Bossier City, Louisiana |
| Authorized Official Name and Position | Carter Jesse Boyd (OWNER) |
| Authorized Official Contact | 3187461094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boyd Family Practice Llc 1518 Doctors Dr Bossier City LA 71111-3322 Ph: (318) 746-1094 | Boyd Family Practice Llc 1518 Doctors Dr Bossier City LA 71111-3322 Ph: (318) 746-1094 |
| NPI Number | 1346389970 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 09/05/2007 |
| Medicare PECOS PAC ID | 5890851794 |
|---|---|
| Medicare Enrollment ID | O20090302000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346389970 | NPI | - | NPPES |
| 1345784 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 016812 (Louisiana) | Primary |
| Provider Name | Carter J Boyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982713483 PECOS PAC ID: 3971669870 Enrollment ID: I20100104000620 |
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