Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS0091962 | PA |
N | 207XS0106X | Orthopaedic Hand Surgeon | OS0091962 | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | OS0091962 | PA |
N | 207XS0117X | Orthopaedic Spine Surgeon | OS0091962 | PA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS0091962 | PA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | OS0091962 | PA |
N | 207XX0801X | Orthopaedic Trauma Surgeon | OS0091962 | PA |
N | 208200000X | Surgeon | OS0091962 | PA |
N | 208600000X | Surgeon | OS0091962 | PA |
NPI | 1245208826 |
---|---|
Provider Name | Dr. Scott John Boyle |
First Address | Hazle Township, PA 18202-1471 |
Second Address | Hazle Township, PA 18202-1471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017960400004 | (05) | PA |
1367821 | BLUE SHIELD (01) | PA |
200044211 | MC RAILROAD INDIVIDUAL # (01) | PA |
50000335 | CBC INDIVIDUAL # (01) | PA |
7133212 | AETNA (01) | PA |
814625 | FIRST PRIORITY HEALTH (01) | PA |
H15381 | (02) | PA |