Provider Demographics
NPI:1053525501
Name:BOYD, LILLIAN KIZER (MD)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:KIZER
Last Name:BOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2607 OFFICE PL
Practice Address - Street 2:STE A
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9437
Practice Address - Country:US
Practice Address - Phone:919-739-9060
Practice Address - Fax:919-739-9099
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242828207R00000X, 207RG0300X
NC2011-00137207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1619JOtherBCBSNC
NC5916975Medicaid
NC5916975Medicaid