Russell Craig Boyd
Individual provider Active NPI Physical Therapist · Summit, MS
NPI 1629338108 · NPPES record last updated Aug 1, 2013
Key facts
- NPI
- 1629338108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 4109 Highway 98 W
Summit, MS 39666-9132 - Phone
- (601) 276-3909
- NPI assigned
- May 18, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
4109 Highway 98 W
Summit, MS 39666-9132
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Other providers in Summit, MS
- Debra Beckett
- Anna Bell
- Jacqueline Denise Bell
- Laura Black
- Karen Boone
- Leslie Brewer
- Bridget S Bridges
- Amy Brown
- Sarah Brumfield
- Brelon T Bryant
All providers in Summit, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.