Provider Demographics
NPI:1730620162
Name:O'BOYLE, HILLARY (MD)
Entity type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:
Last Name:O'BOYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HILLARY
Other - Middle Name:ANN
Other - Last Name:MCCLINTIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 980325
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:804-827-1701
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5023
Practice Address - Country:US
Practice Address - Phone:804-628-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-18
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101270016208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program