Provider Demographics
NPI:1972506012
Name:BOYLE, PAULA JEAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582-4315
Mailing Address - Country:US
Mailing Address - Phone:706-439-6873
Mailing Address - Fax:706-439-6874
Practice Address - Street 1:1155 MAIN ST
Practice Address - Street 2:
Practice Address - City:YOUNG HARRIS
Practice Address - State:GA
Practice Address - Zip Code:30582-4315
Practice Address - Country:US
Practice Address - Phone:706-439-6873
Practice Address - Fax:706-439-6874
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55928207Q00000X
GA055928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA981235OtherBCBS
GA981235OtherBCBS
H04498Medicare UPIN