Provider Demographics
NPI:1780853838
Name:HARRY G. BOYE JR., M.D., PC
Entity Type:Organization
Organization Name:HARRY G. BOYE JR., M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOYE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:865-882-8372
Mailing Address - Street 1:415 DEVONIA ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2025
Mailing Address - Country:US
Mailing Address - Phone:865-882-8372
Mailing Address - Fax:
Practice Address - Street 1:415 DEVONIA ST
Practice Address - Street 2:SUITE 302
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2025
Practice Address - Country:US
Practice Address - Phone:865-882-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12248208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0056130OtherBCBS
TN0056130OtherBCBS
C46907Medicare UPIN