Provider Demographics
NPI:1932404647
Name:BOYES PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:BOYES PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-271-5565
Mailing Address - Street 1:18181 OAKWOOD BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-5032
Mailing Address - Country:US
Mailing Address - Phone:313-271-5565
Mailing Address - Fax:313-271-1053
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5032
Practice Address - Country:US
Practice Address - Phone:313-271-5565
Practice Address - Fax:313-271-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty