Individual
GERALD D BOYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10109 E 79TH ST, TULSA, OK 74133-4564
(918) 286-5131
Mailing address
15380 S 4210 RD, CLAREMORE, OK 74017-0687
(918) 343-3311
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19392
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100082130A
—
OK
Enumeration date
10/19/2005
Last updated
08/29/2012
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