MEDICARE: DR. JOSEPH EUGENE OBOYLE 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	207W00000X	Ophthalmology Physician	0101053739	VA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083614408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH EUGENE OBOYLE M.D.

Provider Business Mailing Address
First Line	:	125 EXECUTIVE DR
Second Line	:	SUITEE, PIEDMONT REGIONAL EYE CENTER
City	:	DANVILLE
State	:	VA
Zip	:	24541-4155
Country	:	US
Telephone Number	:	434-799-5600
Fax Number	:	434-791-1427

Provider Business Practice Location Address
First Line	:	125 EXECUTIVE DR
Second Line	:	SUITEE, PIEDMONT REGIONAL EYE CENTER
City	:	DANVILLE
State	:	VA
Zip	:	24541-4155
Country	:	US
Telephone Number	:	434-799-5600
Fax Number	:	434-791-1427

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	02/25/2010

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