Provider Demographics
NPI:1881021012
Name:BOYLE HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:BOYLE HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:928-774-0108
Mailing Address - Street 1:1515 N SAN FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1435
Mailing Address - Country:US
Mailing Address - Phone:928-774-0108
Mailing Address - Fax:928-774-2801
Practice Address - Street 1:1515 N SAN FRANCISCO ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1435
Practice Address - Country:US
Practice Address - Phone:928-774-0108
Practice Address - Fax:928-774-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ381482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ389992Medicaid
AZ1417127564OtherDR. BOYLE'S PERSONAL NPI