Provider Demographics
NPI:1356431407
Name:BOYD, WILLIAM R JR (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:BOYD
Suffix:JR
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 1:781 SUNSET DR
Mailing Address - Street 2:P.O. BOX 733
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5634
Mailing Address - Country:US
Mailing Address - Phone:423-775-3618
Mailing Address - Fax:423-775-3618
Practice Address - Street 1:781 SUNSET DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5634
Practice Address - Country:US
Practice Address - Phone:423-775-3618
Practice Address - Fax:423-775-3618
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0001746103TC0700X, 106H00000X, 101Y00000X, 101YM0800X, 103TA0700X, 103T00000X, 103TB0200X, 103TC1900X, 103TF0000X, 103TH0004X
TNLPC000262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3689950Medicare ID - Type UnspecifiedPSYCHOLOGIST