Kelly Patrice Boggan M.D.

NPI 1003923962 - Pediatrics - 208000000X

NPI Details
NPI 1003923962
Gender Female
Enumeration Date 08/24/2006
Last Updated 01/21/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
1400 DUTCH VALLEY DRIVE
KNOXVILLE TN, 37918, US
Phone (865) 689-1122
Fax (865) 689-2923
Business Location
PO BOX 15004
KNOXVILLE TN, 37901, US
Phone (865) 522-9730
Fax (865) 637-2520
Toxanomy
Taxonomy Code 208000000X
License State Tennessee
License Number 24699
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According to our database, Dr. Kelly Patrice Boggan M.D. NPI is 1003923962, taxonomy code is 208000000X and license number is 24699, license state is located at Tennessee. Kelly Patrice Boggan M.D. physically located at 1400 Dutch Valley Drive, Knoxville TN, 37918. NPI Number Kelly Patrice Boggan M.D. has the Individual type.

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1003923962 NPI number is provided on an as is basis without warranty of any kind. 1003923962 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly Patrice Boggan M.D. are for informational purposes only.