Provider Demographics
NPI:1003805144
Name:BOYLE, JOHN J (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:BOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:460 TOTTEN POND RD
Mailing Address - Street 2:C/O MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1991
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9930
Practice Address - Street 1:4 STATE RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2567
Practice Address - Country:US
Practice Address - Phone:978-774-3400
Practice Address - Fax:978-774-5884
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2012-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA53963207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17787OtherHPHC
MA053963OtherTUFTS
MAJ04044OtherBCBS
MAJ04044Medicare ID - Type Unspecified
MA17787OtherHPHC