Provider Demographics
NPI:1093787277
Name:BOYLE, PATRICK KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:KEVIN
Last Name:BOYLE
Suffix:
Gender:M
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:UPH-ANESTHESIOLOGY
Mailing Address - Street 2:1501 N CAMPBELL AVE - PO BOX 245114
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5114
Mailing Address - Country:US
Mailing Address - Phone:520-626-7221
Mailing Address - Fax:520-626-6066
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:BOX 245114
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-7221
Practice Address - Fax:520-626-6066
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80342207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ114957OtherMEDICARE
AZ209441Medicaid
AZP00435417OtherRR MEDICARE
AZP00435417OtherRR MEDICARE