person
Mr. Michael Dahyl Boggan, MD
General Practice Physician in Kingsport, Tennessee
NPI 1003844812

Michael Dahyl Boggan is a General Practice Physician based in Kingsport, TN. Michael Dahyl Boggan practices in Kingsport, TN and has the professional credentials of MD. The NPI Number for Michael Dahyl Boggan is 1003844812 and holds a License No. 21139 (Tennessee).

The current practice location address for Michael Dahyl Boggan is 111 W Stone Dr, Kingsport, TN and can be reached out via phone at 423-247-5197 and via fax at 423-247-5254.

Location: 111 W Stone Dr, Kingsport, TN, 37660-6027
person
Provider Profile Details
NPI Number
1003844812
Provider Name
Michael Dahyl Boggan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
111 W Stone Dr, Kingsport, TN, 37660-6027
Phone Number
423-247-5197
Fax Number
423-247-5254
Provider Enumeration Date
06/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1000908 05 TN
3057903 05 TN
P00262488 05 KY
010199743 05 VA
621112685 01 TN UNITED HEALTH CARE
65906208 05 KY
Z101 01 TN UNITED HEALTHCARE OF THE RIVER VALLEY
institution
Provider Business Practice Location Address Details
Address
111 W Stone Dr
City
State
Zip
37660-6027
Phone Number
423-247-5197
Fax Number
423-247-5254
person
Provider Business Mailing Address Details
Address
111 W Stone Dr
City
State
Zip
37660-6027
Phone Number
423-247-5197
Fax Number
423-247-5254
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
21139 (Tennessee)
Definition
Definition to come...
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