Provider Demographics
NPI:1043298011
Name:BOYLE, GINGER BLATCHFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:BLATCHFORD
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1200 E MAIN ST
Practice Address - Street 2:SUTE 12
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1711
Practice Address - Country:US
Practice Address - Phone:864-560-9260
Practice Address - Fax:864-560-9265
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCB27170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC41564722OtherMEDICARE PIN
SCSC41566084OtherMEDICARE PIN
SCSC4156J577OtherMEDICARE PIN
SCSC41566067OtherMEDICARE PIN
SC271707Medicaid
SCP01109437OtherRAILROAD MEDICARE
SCSC41566067Medicare PIN
SCSC41566067Medicare PIN