Provider Demographics
NPI:1518276617
Name:JOY R. BOYNE MD PA
Entity Type:Organization
Organization Name:JOY R. BOYNE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-281-1988
Mailing Address - Street 1:6869 BELFORT OAKS PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6242
Mailing Address - Country:US
Mailing Address - Phone:904-281-1988
Mailing Address - Fax:904-281-0852
Practice Address - Street 1:6869 BELFORT OAKS PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6242
Practice Address - Country:US
Practice Address - Phone:904-281-1988
Practice Address - Fax:904-281-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51530207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070013112OtherRAILROAD MEDICARE
FL10351OtherBLUE CROSS BLUE SHIELD FL
FL2121184OtherAETNA
FLE71121Medicare UPIN
FL2121184OtherAETNA