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General NPI Number Information
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NPI Number | 1972683597
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Entity Type | Individual
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Provider Name | MEADE P O'BOYLE M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 3510 MEDICAL PARK DR STE 3
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City | MONROE
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State | LA
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Zip | 71203-2363
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Country | US
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Telephone | 318-966-6165
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Fax | 318-966-6632
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Provider Business Mailing Address
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Address Line | 1217 DEAN CHAPEL RD
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City | WEST MONROE
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State | LA
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Zip | 71291-7609
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Country | US
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Telephone | 318-366-4002
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Fax | 318-966-6165
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4039R
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License Number State | LA
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