Provider Demographics
NPI:1083614408
Name:OBOYLE, JOSEPH EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EUGENE
Last Name:OBOYLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:125 EXECUTIVE DR
Mailing Address - Street 2:SUITEE, PIEDMONT REGIONAL EYE CENTER
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4155
Mailing Address - Country:US
Mailing Address - Phone:434-799-5600
Mailing Address - Fax:434-791-1427
Practice Address - Street 1:125 EXECUTIVE DR
Practice Address - Street 2:SUITEE, PIEDMONT REGIONAL EYE CENTER
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4155
Practice Address - Country:US
Practice Address - Phone:434-799-5600
Practice Address - Fax:434-791-1427
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053739207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890649NMedicaid
VA6303960Medicaid
NC890649NMedicaid
VA6303960Medicaid