Provider Demographics
NPI:1114065893
Name:COLE, BOYD NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:BOYD
Middle Name:NEIL
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1002 E SOUTH TEMPLE
Mailing Address - Street 2:#205
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1525
Mailing Address - Country:US
Mailing Address - Phone:801-533-0324
Mailing Address - Fax:801-539-0220
Practice Address - Street 1:1002 E SOUTH TEMPLE
Practice Address - Street 2:#205
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1525
Practice Address - Country:US
Practice Address - Phone:801-533-0324
Practice Address - Fax:801-539-0220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT157681-1205207Y00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07346Medicare UPIN