Provider Demographics
NPI:1831189695
Name:BOYER, MICHAEL FRANK (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FRANK
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 1:4 E CLARK BASS BLVD
Mailing Address - Street 2:SUITE # 205
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4285
Mailing Address - Country:US
Mailing Address - Phone:918-421-8897
Mailing Address - Fax:918-302-0825
Practice Address - Street 1:4 E CLARK BASS BLVD
Practice Address - Street 2:SUITE # 205
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4285
Practice Address - Country:US
Practice Address - Phone:918-421-8897
Practice Address - Fax:918-302-0825
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13645207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100190100AMedicaid
OK100190100AMedicaid