Provider Demographics
NPI:1962570713
Name:BOYES, JAMES BURDETTE (RPAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BURDETTE
Last Name:BOYES
Suffix:
Gender:M
Credentials:RPAC
Other - Prefix:
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Mailing Address - Street 1:6815 HILLTOP RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226
Mailing Address - Country:US
Mailing Address - Phone:913-422-2020
Mailing Address - Fax:913-441-6847
Practice Address - Street 1:33490 LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:KS
Practice Address - Zip Code:66018
Practice Address - Country:US
Practice Address - Phone:913-583-1179
Practice Address - Fax:913-583-3667
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1500466363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S54291Medicare UPIN
C489843Medicare ID - Type Unspecified