Provider Demographics
NPI:1104824853
Name:BOYER, JAMES (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BOYER
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BOYLSTON ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2007
Mailing Address - Country:US
Mailing Address - Phone:814-368-1020
Mailing Address - Fax:814-368-1024
Practice Address - Street 1:54 BOYLSTON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2007
Practice Address - Country:US
Practice Address - Phone:814-368-1020
Practice Address - Fax:814-368-1024
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002677L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA018750G3PMedicare ID - Type Unspecified
NYBB2469Medicare PIN
PAJ33744Medicare UPIN