Individual
DR. BRIAN A. BOATWRIGHT
Active
Individual
DR. BRIAN A. BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1144
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295091411
MEDICARE GROUP NPI
—
05
—
200463840A
—
OK
Enumeration date
08/17/2011
Last updated
04/26/2013
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