Provider Demographics
NPI:1396740403
Name:BOYLE, BRIAN FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:FRANCIS
Last Name:BOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 RICHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1028
Mailing Address - Country:US
Mailing Address - Phone:724-832-9590
Mailing Address - Fax:724-834-0130
Practice Address - Street 1:1211 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5319
Practice Address - Country:US
Practice Address - Phone:724-832-9590
Practice Address - Fax:724-834-0130
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038301-E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011665400004Medicaid
PA920978OtherFIRST HEALTH
PA3843715OtherCIGNA
PA502360OtherPA BLUE SHIELD
PA000000087385OtherTHREE RIVERS MEDPLUS
PA1013315OtherGATEWAY
PA207537OtherUPMC
PA46004OtherHEALTH AMERICA/ASSURANCE
PA251642020OtherTRICARE (CHAMPUS)
PA466768OtherAETNA
PA251642020OtherUNITEDHEALTHCARE
PA250005646OtherPALMETTO GBA
PA1013315OtherGATEWAY
PA502360Medicare ID - Type Unspecified