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General NPI Number Information
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NPI Number | 1508705567
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Entity Type | Individual
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Provider Name | WILLIAM BOERGER
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Gender | Male
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 691 SCOUT CIR
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City | HERNANDO
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State | MS
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Zip | 38632-1921
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Country | US
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Telephone | 386-624-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 691 SCOUT CIR
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City | HERNANDO
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State | MS
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Zip | 38632-1921
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Country | US
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Telephone | 386-624-3613
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | 070307-01
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License Number State | NY
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