Individual
GARY ALLEN BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2100 W IOWA AVE, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2310
Mailing address
2100 W IOWA AVE, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2310
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
2257
OK
2083X0100X
Occupational Medicine Physician
Primary
2257
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100100940A
—
OK
01
—
P00854127
MEDICARE RR PTAN
OK
Enumeration date
12/06/2006
Last updated
03/17/2018
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