Boston, Gary Deaver

Boston, Gary Deaver is an individual health care provider with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Boston, Gary Deaver can be contacted via phone (602) 263-1200.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Phone: (602) 263-1200
Fax: (602) 200-5383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 0418345 Kansas

Profile Details

NPI number 1063414241
LBN Legal business name Boston, Gary Deaver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Oct 21st, 2015 - about 9 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 1063414241 NPPES
Kansas MEDICAID 100083430A
Kansas MEDICAID 201305919

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