Provider Demographics
NPI:1821100322
Name:BOYER, ROCH R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCH
Middle Name:R
Last Name:BOYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 SURGICAL SERVICES WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4844
Mailing Address - Country:US
Mailing Address - Phone:406-752-5000
Mailing Address - Fax:406-752-8220
Practice Address - Street 1:1333 SURGICAL SERVICES WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4844
Practice Address - Country:US
Practice Address - Phone:406-752-5000
Practice Address - Fax:406-752-8220
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6826208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM011000973Medicare PIN