MEDICARE: WHITNEY BOGGS M.D.

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	25162	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407149750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY BOGGS M.D.

Provider Business Mailing Address
First Line	:	497 MALL RD
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-6216
Country	:	US
Telephone Number	:	304-469-2905
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 FAIRVIEW HEIGHTS RD
Second Line	:
City	:	SUMMERSVILLE
State	:	WV
Zip	:	26651-1086
Country	:	US
Telephone Number	:	304-469-2905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	10/09/2023

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Directions to “ WHITNEY BOGGS M.D.” Practice Location

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