Mr Michael Dahyl Boggan, MD is a
General Practice physician based in Kingsport, Tennessee. Mr Michael Dahyl Boggan is licensed to practice in Tennessee (license number 21139) and his current practice location is 111 W Stone Dr, Suite 100, Kingsport, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(423) 247-5197.
NPI number for Mr Michael Dahyl Boggan is 1003844812 and his current mailing address is 111 W Stone Dr, Suite 100, Kingsport, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003844812.
Physician's Profile
| Full Name | Mr Michael Dahyl Boggan |
|---|
| Gender | Male |
|---|
| Speciality | General Practice |
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| Location | 111 W Stone Dr, Kingsport, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003844812
- Provider Enumeration Date: 06/29/2006
- Last Update Date: 08/06/2012
Medical Identifiers
Medical identifiers for Mr Michael Dahyl Boggan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003844812 | NPI | - | NPPES |
| 1000908 | Medicaid | TN | |
| 3057903 | Medicaid | TN | |
| P00262488 | Medicaid | KY | |
| 010199743 | Medicaid | VA | |
| 621112685 | Other | TN | UNITED HEALTH CARE |
| 65906208 | Medicaid | KY | |
| Z101 | Other | TN | UNITED HEALTHCARE OF THE RIVER VALLEY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 21139 (Tennessee) | Primary |
| 208D00000X | General Practice | 0101246769 (Virginia) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Michael Dahyl Boggan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Michael Dahyl Boggan, MD
111 W Stone Dr, Suite 100,
Kingsport, TN 37660-6027
Ph: (423) 245-5197 | Mr Michael Dahyl Boggan, MD
111 W Stone Dr, Suite 100,
Kingsport, TN 37660-6027
Ph: (423) 247-5197 |
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