Provider Demographics
NPI:1184999625
Name:GUYMON, NEAL BOYD (OD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:BOYD
Last Name:GUYMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1689 PANCHERI DR
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-3169
Mailing Address - Country:US
Mailing Address - Phone:208-529-4333
Mailing Address - Fax:208-529-4366
Practice Address - Street 1:1689 PANCHERI DR
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3169
Practice Address - Country:US
Practice Address - Phone:208-529-4333
Practice Address - Fax:208-529-4366
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP-100325152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist