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NPI Code Detail

MEDICARE: JOHN W BOYLE IV M.D.

MEDICARE:   JOHN W BOYLE IV 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
1207W00000XOphthalmology Physician42067TN
2207WX0009XGlaucoma Specialist (Ophthalmology) Physician201770LA
3207W00000XOphthalmology Physician201770LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225177009
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W BOYLE IV M.D.
Provider Business Mailing Address
First Line : 4224 HOUMA BLVD.
Second Line : SUITE 100
City : METAIRIE
State : LA
Zip : 70006
Country : US
Telephone Number : 504-454-1000
Fax Number : 504-456-8010
Provider Business Practice Location Address
First Line : 4224 HOUMA BLVD
Second Line : SUITE 100 GULF SOUTH EYE ASSOCIATES, APMC
City : METAIRIE
State : LA
Zip : 70006
Country : US
Telephone Number : 504-454-1000
Fax Number : 504-456-8010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 05/31/2017

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