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General NPI Number Information
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NPI Number | 1386948891
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Entity Type | Individual
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Provider Name | ERIC JAMES BOYER PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 1995 HIGHWAY 51 S
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City | COVINGTON
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State | TN
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Zip | 38019-3635
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Country | US
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Telephone | 901-476-2621
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 DOVER PL SE
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City | CONYERS
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State | GA
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Zip | 30013-4619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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