Individual
BRUCE D BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
124 OLD GRAY STATION RD STE 1, GRAY, TN 37615-3434
(423) 477-0600
(423) 477-0611
Mailing address
124 OLD GRAY STATION RD STE 1, GRAY, TN 37615-3434
(423) 477-0600
(423) 477-0611
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD39382
TN
207Q00000X
Family Medicine Physician
Primary
MD39382
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BLUE CROSS BLUE SHIE
4109177
TN
Enumeration date
04/13/2006
Last updated
08/08/2011
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