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Individual

DR. JACOB MICAH BOYDSTUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(432) 770-5923
Mailing address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(432) 770-5923

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E-9954
AR
390200000X
Student in an Organized Health Care Education/Training Program
AR

Other

Enumeration date
04/11/2013
Last updated
03/19/2018
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