Eric V Boughton, D.C.
Individual provider Active NPI Chiropractor · Ronan, MT
NPI 1104916261 · NPPES record last updated Jan 25, 2017
Key facts
- NPI
- 1104916261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1089 (MT)
- Practice address
- 63228 US Highway 93
Ronan, MT 59864-2836 - Phone
- (406) 871-8347
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120410000760 | MT | Practitioner - Chiropractic | 4789636119 | Practice locations: Ronan, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Aggen Inc. | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1089 | MT | Yes |
Addresses
Primary practice location
63228 US Highway 93
Ronan, MT 59864-2836
Mailing address
63228 US Highway 93
Ronan, MT 59864-2836
Phone (406) 871-8347
Other providers in Ronan, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.