Healthcare Provider Details

I. General information

NPI: 1992025969
Provider Name (Legal Business Name): SEAN BOYLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT RD
CINCINNATI OH
45219-2610
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-3238
  • Fax: 513-585-3254
Mailing address:
  • Phone: 513-351-9900
  • Fax: 513-366-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.010915
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: