Provider Demographics
NPI:1538336011
Name:BOYER, RAY CLEVELAND
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:CLEVELAND
Last Name:BOYER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RAY
Other - Middle Name:CLEVELAND
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:304 STEINER RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6006
Mailing Address - Country:US
Mailing Address - Phone:337-984-4184
Mailing Address - Fax:337-984-2531
Practice Address - Street 1:304 STEINER RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6006
Practice Address - Country:US
Practice Address - Phone:337-984-4184
Practice Address - Fax:337-984-2531
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA116012083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA12134Medicaid