Boley, Jerry Joe

Boley, Jerry Joe is an individual health care provider with primary practice located at 4112 Monroe Rd , Celina OH 45828-9250. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Boley, Jerry Joe can be contacted via phone (614) 580-8563.

Contact Information

Primary practice address
4112 Monroe Rd Celina OH 45828-9250
Phone: (614) 580-8563
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35070190B Ohio

Profile Details

NPI number 1962465435
LBN Legal business name Boley, Jerry Joe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Mar 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962465435 NPPES
Other 289254 BLACK LUNG
Other 1330778 BLACK LUNG
Other 060038975 BLACK LUNG
Other 12723 BLACK LUNG
MEDICAID 0307108 BLACK LUNG
Other 060038975 BLACK LUNG
Other 0000000014726 BLACK LUNG
Other 2500965 BLACK LUNG

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