Provider Demographics
NPI:1538159546
Name:BOYLAN, JAMES J (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:BOYLAN
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 1:306 S NEW ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1112
Mailing Address - Country:US
Mailing Address - Phone:610-866-0113
Mailing Address - Fax:610-974-8589
Practice Address - Street 1:306 S NEW ST STE 201
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1652
Practice Address - Country:US
Practice Address - Phone:610-866-0113
Practice Address - Fax:610-974-8589
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD195987207RG0100X
PAMD020689E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005865770001Medicaid
PA025765Medicare ID - Type Unspecified
PA0005865770001Medicaid