Healthcare Provider Details

I. General information

NPI: 1669473864
Provider Name (Legal Business Name): ROBERT L BOYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 MAJESTIC DR STE 270
LEXINGTON KY
40513-1496
US

IV. Provider business mailing address

1125 SAMUEL CT
UNION KY
41091-7774
US

V. Phone/Fax

Practice location:
  • Phone: 859-446-5603
  • Fax: 859-223-0494
Mailing address:
  • Phone: 859-384-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number26323
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: