Mr Michael Dahyl Boggan, MD in Kingsport, TN - General Practice

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.

Contact Information

	Mr Michael Dahyl Boggan, MD
	111 W Stone Dr, Suite 100, Kingsport, TN 37660-6027
	(423) 247-5197
	(423) 247-5254

Physician's Profile

Full Name	Mr Michael Dahyl Boggan
Gender	Male
Speciality	General Practice
Location	111 W Stone Dr, Kingsport, Tennessee
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

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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Mr Michael Dahyl Boggan, MD - General Practice in Kingsport, TN