Individual
JAMISON T BOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
902 S COURT ST, SUITE #1, TUSCOLA, IL 61953
(217) 235-2220
(217) 253-2292
Mailing address
902 S COURT ST, SUITE #1, TUSCOLA, IL 61953
(217) 253-2220
(217) 253-2292
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008823
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008823
—
IL
01
—
05815176
BLUE CROSS & BLUE SHIELD
IL
01
—
410047783
MEDICARE RR
IL
Enumeration date
03/24/2006
Last updated
02/13/2017
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