MEDICARE: KATHLEEN ANN BOYLS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	17805	OK
2	208000000X	Pediatrics Physician	17805	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134198195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN ANN BOYLS M.D.

Provider Business Mailing Address
First Line	:	5840 S MEMORIAL DR STE 301
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9082
Country	:	US
Telephone Number	:	918-930-6689
Fax Number	:	918-921-8824

Provider Business Practice Location Address
First Line	:	5840 S MEMORIAL DR STE 301
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9082
Country	:	US
Telephone Number	:	918-930-6689
Fax Number	:	918-921-8824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/24/2026

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Directions to “ KATHLEEN ANN BOYLS M.D.” Practice Location

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