Boatwright, Roger Dale

Boatwright, Roger Dale is an individual health care provider with primary practice located at 704 N A St , Easley SC 29640-2142. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Boatwright, Roger Dale can be contacted via phone (864) 859-4480.

Contact Information

Primary practice address
704 N A St Easley SC 29640-2142
Fax: (864) 859-3750
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22401 South Carolina

Profile Details

NPI number 1386628071
LBN Legal business name Boatwright, Roger Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated May 11th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386628071 NPPES
South Carolina MEDICAID L31794

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