Healthcare Provider Details

I. General information

NPI: 1407959760
Provider Name (Legal Business Name): BRETT EUGENE BOICE D. O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NW 1ST LANE
LAMAR MO
64759-8105
US

IV. Provider business mailing address

29 NW 1ST LANE
LAMAR MO
64759-8105
US

V. Phone/Fax

Practice location:
  • Phone: 417-681-5266
  • Fax: 417-681-5526
Mailing address:
  • Phone: 417-681-5266
  • Fax: 417-681-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number105928
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number105928
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: