Boggs, Jerry D.
Boggs, Jerry D. is an individual health care provider with primary practice located at 1741 West Harvard Ave , Roseburg OR 97471-2716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Boggs, Jerry D. can be contacted via phone (541) 440-5320.Contact Information
Primary practice address
1741 West Harvard Ave
Roseburg OR 97471-2716
Phone: (541) 440-5320
Fax: (541) 440-5322
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD20969 | Oregon |
Profile Details
| NPI number | 1003890153 |
|---|---|
| LBN Legal business name | Boggs, Jerry D. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Sep 10th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003890153 | NPPES |
| Oregon | MEDICAID | 151137 |
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