Basic Information
| Provider Information | |||||||||
| NPI: | 1609861392 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYER | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | LOUIS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10099 RIDGE GATE PKWY | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | LONE TREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417611998 | ||||||||
| FaxNumber: | 9417485626 | ||||||||
| Practice Location | |||||||||
| Address1: | 10099 RIDGE GATE PKWY | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | LONE TREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037901800 | ||||||||
| FaxNumber: | 3037901809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2005 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | ME68033 | FL | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | DR0059227 | CO | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 377686700 | 05 | FL | MEDICAID | 9000152452 | 05 | CO | MEDICAID | 26796 | 01 | FL | BCBS | OTHER | 140005631 | 01 | FL | RAIL ROAD MEDICARE | OTHER |