Provider Demographics
NPI:1497715411
Name:BOYER, KIMBERLY FRANTZ (OD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:FRANTZ
Last Name:BOYER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BRETZ CT STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17074-8616
Mailing Address - Country:US
Mailing Address - Phone:717-567-3103
Mailing Address - Fax:717-567-7784
Practice Address - Street 1:300 BRETZ CT STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8616
Practice Address - Country:US
Practice Address - Phone:717-567-3103
Practice Address - Fax:717-567-7784
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU92206Medicare UPIN
PA063322Medicare ID - Type Unspecified