MEDICARE: DUSTIN LAMAR BOYER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	L9634	TX
2	2085R0001X	Radiation Oncology Physician	18784	NV

General Provider Information

NPI Number	:	1538142591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUSTIN LAMAR BOYER M.D.

Provider Business Mailing Address
First Line	:	2160 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1410
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	3006 S MARYLAND PKWY STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2219
Country	:	US
Telephone Number	:	702-894-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	05/24/2019

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