Doctor Name: | SCOTT G BOGGS |
NPI Number: | 1750781027 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | 68576 |
Business Practice Address: | 40 Fairland Dr Nitro, WV - 251431186 |
Business Phone Number: | 3042042430 |
Business Fax Number: | 3043976740 |
Mailing Address: | 40 Fairland Dr, NITRO |
State: | WV |
Postal Code: | 251431186 |
Phone Number: | 3042042430 |
Fax Number: | 3043976740 |
NPI Enumeration Date: | 08/24/2014 |
NPI Last Update Date: | 08/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 68576 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |