Healthcare Provider Details

I. General information

NPI: 1083614408
Provider Name (Legal Business Name): JOSEPH EUGENE OBOYLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 EXECUTIVE DR SUITEE, PIEDMONT REGIONAL EYE CENTER
DANVILLE VA
24541-4155
US

IV. Provider business mailing address

125 EXECUTIVE DR SUITEE, PIEDMONT REGIONAL EYE CENTER
DANVILLE VA
24541-4155
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-5600
  • Fax: 434-791-1427
Mailing address:
  • Phone: 434-799-5600
  • Fax: 434-791-1427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101053739
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: