Boyette Facial Plastic Surgery, PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

E-7894 Issued in AR

Legal business name

BOYETTE FACIAL PLASTIC SURGERY, PA

Practice address

9601 Lile Dr.
Medical Towers Building 1, Suite 970B
Little Rock, AR 72205-6321

Phone

(501) 205-8610

Fax

(501) 205-8610

NPI assigned

May 23, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jennings Russell Boyette, MDNPI 1922216084

Title

Owner

Phone

(501) 205-8610

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennings R Boyette, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Little Rock, AR
  • NPI 1922216084
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1689021420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241212",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230004",
            "telephone_number": "501-205-8610",
            "fax_number": "501-205-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 LILE DR.",
            "address_2": "MEDICAL TOWERS BUILDING 1, SUITE 970B",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-205-8610",
            "fax_number": "501-205-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYETTE FACIAL PLASTIC SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "BOYETTE",
        "authorized_official_first_name": "JENNINGS",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-205-8610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AR",
            "license": "E-7894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Samuel Boyd, PH.D.
• Jacob Micah Boydstun, D.O.
• Gwyneth Boyer
• Maranda Boyer, CRNA
• Rema Lynn Boyer, LPN
• Jennings R Boyette, MD
• Valarie Boyette
• Jerricka S. Boykins
• Ronald Henry Boyle, M.D.
• Caleb B Bozeman, M.D.

• Plastic and Reconstructive Surgery Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Plastic and Reconstructive Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.