Basic Information
Provider Information
NPI: 1336434547
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOYLES
FirstName: AARON
MiddleName: DAVIS
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2425 STOCKTON BLVD
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958172215
CountryCode: US
TelephoneNumber: 9164532000
FaxNumber:  
Practice Location
Address1: 13123 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800457106
CountryCode: US
TelephoneNumber: 7208480000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/15/2011
LastUpdateDate: 05/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X20A14413CAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home