MEDICARE: PATRICK JAMES BOYLE MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD29083	OR

General Provider Information

NPI Number	:	1184630816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK JAMES BOYLE MD

Provider Business Mailing Address
First Line	:	539 NW HWY 101
Second Line	:	SUITE A
City	:	DEPOE BAY
State	:	OR
Zip	:	97341
Country	:	US
Telephone Number	:	541-765-3265
Fax Number	:

Provider Business Practice Location Address
First Line	:	539 NW HWY 101
Second Line	:	SUITE A
City	:	DEPOE BAY
State	:	OR
Zip	:	97341
Country	:	US
Telephone Number	:	541-765-3265
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	08/11/2011

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