Individual
ROGER DALE BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
704 N A ST, EASLEY, SC 29640-2142
(864) 859-4480
(864) 859-3750
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22401
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L31794
—
SC
Enumeration date
12/06/2005
Last updated
05/11/2021
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