Individual
MICHAEL A. BOGGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
213 OVERLOOK CIR STE B3, BRENTWOOD, TN 37027-3241
(615) 942-8016
(615) 739-5376
Mailing address
213 OVERLOOK CIR STE B3, BRENTWOOD, TN 37027-3241
(615) 942-8016
(615) 739-5376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31982
KY
207YS0123X
Facial Plastic Surgery Physician
Primary
44489
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64007750
—
KY
05
—
Q017030
—
TN
Enumeration date
02/27/2006
Last updated
11/22/2015
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