Basic Information
Provider Information
NPI: 1366686446
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOYD
FirstName: KATHRYN
MiddleName: DAWN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 110429
Address2: UNIVERSITY PHYSICIANS INC
City: AURORA
State: CO
PostalCode: 800420429
CountryCode: US
TelephoneNumber: 7204937000
FaxNumber:  
Practice Location
Address1: 12605 EAST 16TH AVE
Address2: UNIVERSITY OF COLORADO HOSPITAL
City: AURORA
State: CO
PostalCode: 80045
CountryCode: US
TelephoneNumber: 7208480000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/21/2009
LastUpdateDate: 11/15/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XDR.0051445CON Allopathic & Osteopathic PhysiciansInternal Medicine 
207Q00000XDR.0051445COY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home