Provider Demographics
NPI:1750380309
Name:BOYD, CLARENCE DEWAYNE (RPH)
Entity type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:DEWAYNE
Last Name:BOYD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8816 DEERBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-3237
Mailing Address - Country:US
Mailing Address - Phone:205-647-4553
Mailing Address - Fax:
Practice Address - Street 1:2708 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3406
Practice Address - Country:US
Practice Address - Phone:205-297-0075
Practice Address - Fax:205-297-0074
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12389183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N0905XPharmacy Service ProvidersPharmacistNuclear