Jeffrey Allen Boggs, D.C.
Individual provider Active NPI Chiropractor · Glasgow, KY
NPI 1972698280 · NPPES record last updated Aug 20, 2014
Key facts
- NPI
- 1972698280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4170 (KY)
- Practice address
- 102 W Cherry St
Glasgow, KY 42141-2902 - Phone
- (270) 651-7552
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4170 | KY | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4170 | KY | Yes |
Addresses
Primary practice location
102 W Cherry St
Glasgow, KY 42141-2902
Mailing address
106 Shane Drive
St 20
Glasgow, KY 42141
Phone (270) 651-7552
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85041705 | Medicaid | KY |
Other providers in Glasgow, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.