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Contact Information

KENNETH A BOYLE SR, OD
7875 JOHNNY CAKE RIDGE RD
GREAT LAKES MALL
MENTOR, OH44060-5529
 Phone: 440-255-2176
 Fax: 440-255-1094
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KENNETH A BOYLE SR · (Male)

NPI Number 1184673576
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/10/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • OH License # 2758
  • OH Medicaid 0002124
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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