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Individual

CASEY J BOYLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2375 EDGEWOOD RD SW, CEDAR RAPIDS, IA 52404-4736
(319) 396-1983
(319) 396-3183
Mailing address
2375 EDGEWOOD RD SW, CEDAR RAPIDS, IA 52404-4736
(319) 396-1983
(319) 396-3183

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33714
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080176890
RR MEDICARE
IA
05
1669459921
IA
05
2203042
IA
05
3203042
IA
05
5203042
IA
Enumeration date
12/28/2005
Last updated
05/16/2012
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