Justin Joel Boe, M.D.
Radiology, Diagnostic Radiology in Edmond, OK. Individual provider (NPI-1).
NPI number1205925864
StatusActive
Last updated in NPPESJun 24, 2015
Details
- NPI
- 1205925864
- Entity type
- Individual (NPI-1)
- Name
- Justin Joel Boe
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2006
- Last updated
- Jun 24, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 25546 | OK | Yes |
| 208000000X | Pediatrics | A97272 | CA | |
| 2085R0202X | Radiology, Diagnostic Radiology | A97272 | CA | |
| 2085R0202X | Radiology, Diagnostic Radiology | 44935 | KY |
Practice location
1408 Glenolde PlEdmond, OK 73003-2668
Phone 952-595-1301 · Fax 612-294-4903
Mailing address
11995 Singletree LnSuite 500
Eden Prairie, MN 55344-5347
Phone 952-595-1301 · Fax 612-294-4903
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