Organization
GORDON R. BOYD O.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON R. BOYD O.D. (PRESIDENT/OPTOMETRIST)
(765) 362-3209
Entity
Organization
Contact information
Practice address
1485 S. GRANT AVE, SUITE A, CRAWFORDSVILLE, IN 47933-3329
(765) 362-3209
(765) 364-9233
Mailing address
1485 S. GRANT AVE, SUITE A, CRAWFORDSVILLE, IN 47933-3329
(765) 362-3209
(765) 364-9233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0474130001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U25862
VSP
IN
Enumeration date
10/05/2007
Last updated
04/01/2008
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