Individual
DR. BRICE T. BOUGHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 381-1111
(931) 552-6663
Mailing address
PO BOX 3239, INDIANAPOLIS, IN 46206-3239
(844) 295-4871
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
18552
MS
2085R0202X
Diagnostic Radiology Physician
Primary
44452
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30027211
—
TN
01
—
P00687770
RAILROAD MEDICARE
TN
Enumeration date
05/25/2006
Last updated
08/04/2021
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