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General NPI Number Information
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NPI Number | 1790123743
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Entity Type | Individual
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Provider Name | DEREK A BOYER PA
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Gender | Male
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 322 MULBERRY ST SW STE A
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City | LENOIR
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State | NC
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Zip | 28645-5703
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Country | US
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Telephone | 828-757-6460
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Fax | 828-759-4901
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Provider Business Mailing Address
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Address Line | 1834 SW 1ST AVE SUITE 201
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City | OCALA
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State | FL
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Zip | 34471-8100
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Country | US
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Telephone | 352-732-9888
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Fax | 352-732-0490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 9107230
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-06304
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License Number State | NC
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