NPI 1003844812

Michael Dahyl Boggan, MD

Practitioner General Practice Physician Kingsport, TN

Practice location

Address: 111 W Stone Dr Suite 100, Kingsport, TN 37660-6027
Phone: (423) 247-5197
Fax: (423) 247-5254

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 21139 (TN)

Other General Practice providers in Tennessee →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 0101246769 (VA)

Registry record

NPI: 1003844812
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jun 2006
Record last updated: 6 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.