Physician Compare National (NPI:1003916602)

HEALTHCARE PROVIDER: FRED F BOYKIN MSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003916602
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204992258
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170622002664
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOYKIN
	Individual professional last name
Provider First Name	FRED
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2312 WILTON DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 29
	Group Practice or individual's line 2 address
City	WILTON MANORS
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	333051249
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3014043602
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y