Provider Demographics
NPI:1447356340
Name:BOYER, KIMBERLY BRIAN (OD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BRIAN
Last Name:BOYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:B
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825
Mailing Address - Country:US
Mailing Address - Phone:603-664-5794
Mailing Address - Fax:603-926-2898
Practice Address - Street 1:28 E DEPOT SQ
Practice Address - Street 2:H AMPTON VISION CENTER
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842
Practice Address - Country:US
Practice Address - Phone:603-926-2722
Practice Address - Fax:603-926-2898
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH529152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80008205Medicaid
MB0333497OtherDEA#
BORE4763Medicare ID - Type Unspecified
NH80008205Medicaid