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NPI Code Detail

MEDICARE: DR. JUDITH J BOGGESS M.D.

MEDICARE: DR. JUDITH J BOGGESS 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
1207R00000XInternal Medicine Physician41642TN

General Provider Information

NPI Number : 1457315848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDITH J BOGGESS M.D.
Provider Business Mailing Address
First Line : 1508 TOMBRAS AVE
Second Line :
City : EAST RIDGE
State : TN
Zip : 37412-2720
Country : US
Telephone Number : 423-867-4969
Fax Number : 423-805-4213
Provider Business Practice Location Address
First Line : 1508 TOMBRAS AVE
Second Line :
City : EAST RIDGE
State : TN
Zip : 37412-2720
Country : US
Telephone Number : 423-867-4969
Fax Number : 423-805-4213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 11/23/2019

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Directions to “ DR. JUDITH J BOGGESS M.D.” Practice Location

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