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NPI Code Detail

MEDICARE: DONALD BOATRIGHT, MD., PC

MEDICARE: DONALD BOATRIGHT, MD., PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine Physician16522TN
2207R00000XInternal Medicine Physician16522TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32566732OTHERTNCIGNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
54058614OTHERTNBCBS
67574554OTHERTNAETNA

General Provider Information

NPI Number : 1568723088
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONALD BOATRIGHT, MD., PC
Provider Business Mailing Address
First Line : 607 W DUE WEST AVE STE 113
Second Line :
City : MADISON
State : TN
Zip : 37115-4428
Country : US
Telephone Number : 615-865-6269
Fax Number : 651-865-4169
Provider Business Practice Location Address
First Line : 607 W DUE WEST AVE STE 113
Second Line :
City : MADISON
State : TN
Zip : 37115-4428
Country : US
Telephone Number : 615-865-6269
Fax Number : 651-865-4169
Authorized Official
Title or Position : PHYSICIAN
Name : DR. DONALD BOATRIGHT J BOATRIGHT
Credential : MD
Telephone Number : 615-865-6269
Provider Enumeration Date : 05/31/2012
Last Update Date : 05/31/2012

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Directions to “DONALD BOATRIGHT, MD., PC ” Practice Location

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