Individual
DR. CARL ANTHONY BOYKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
217 S EXTENSION ST, HAZLEHURST, MS 39083-3322
(601) 812-8686
Mailing address
217 SOUTH EXTENSION STREET, HAZLEHURST, MS 39083
(601) 812-8686
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3431-07
MS
1223G0001X
General Practice Dentistry
Primary
6824
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06457826
—
MS
Enumeration date
01/07/2008
Last updated
08/25/2017
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