Provider Demographics
NPI:1629163373
Name:BOYE, JR., HARRY G (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:G
Last Name:BOYE, JR.
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 1:415 DEVONIA STREET
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748
Mailing Address - Country:US
Mailing Address - Phone:865-882-8372
Mailing Address - Fax:865-882-8372
Practice Address - Street 1:415 DEVONIA STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748
Practice Address - Country:US
Practice Address - Phone:865-882-8372
Practice Address - Fax:865-882-8372
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD012248208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4034493OtherAETNA
TN3005484Medicaid
TN56130OtherBLUECROSS BLUE SHIELD
TN4034493OtherAETNA
TN56130OtherBLUECROSS BLUE SHIELD