Individual
DR. ROBERT BRUCE BOYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2757 S SENECA ST, WICHITA, KS 67217-2862
(316) 260-6280
(316) 665-6806
Mailing address
2757 S SENECA ST, WICHITA, KS 67217-2862
(316) 260-6280
(316) 665-6806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1473-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100363120E
—
KS
01
—
1558670760
BC/BS
KS
01
—
27-3461950
FEDERAL TAX ID
KS
01
—
3239530
CIGNA
KS
01
—
5062
PPK
KS
01
—
545740
COVENTRY
KS
Enumeration date
10/03/2006
Last updated
10/03/2013
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