Provider Demographics
NPI:1972009470
Name:BOYLAN LLC
Entity Type:Organization
Organization Name:BOYLAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:615-589-8652
Mailing Address - Street 1:1406 MCGAVOCK PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-3233
Mailing Address - Country:US
Mailing Address - Phone:615-589-8652
Mailing Address - Fax:
Practice Address - Street 1:1406 MCGAVOCK PIKE STE B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-3233
Practice Address - Country:US
Practice Address - Phone:615-589-8652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty