Provider Demographics
NPI:1548933831
Name:BOYD, KENNETH RAY II
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:RAY
Last Name:BOYD
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 MEEKISON ST
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-2137
Mailing Address - Country:US
Mailing Address - Phone:419-901-4507
Mailing Address - Fax:
Practice Address - Street 1:334 MEEKISON ST
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-2137
Practice Address - Country:US
Practice Address - Phone:419-901-4507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker