Healthcare Provider Details

I. General information

NPI: 1790976801
Provider Name (Legal Business Name): RICHARD BOYCE CRNA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 WASHINGTON BLVD STE 105
OGDEN UT
84401-4149
US

IV. Provider business mailing address

PO BOX 837
OGDEN UT
84402-0837
US

V. Phone/Fax

Practice location:
  • Phone: 801-392-0385
  • Fax: 801-393-3334
Mailing address:
  • Phone: 801-392-0385
  • Fax: 801-393-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number972163844406
License Number StateUT

VIII. Authorized Official

Name: MR. RICHARD A BOYCE
Title or Position: PRESIDENT
Credential: C.R.N.A.
Phone: 801-392-0385