Individual
DR. PATRICIA JEAN BOUKNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6193
(864) 560-1510
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18076
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080135335
RR MEDICARE
SC
05
—
180761
—
SC
01
—
G497073365
MEDICARE
SC
01
—
P01221633
RAILROAD MEDICARE
SC
Enumeration date
02/21/2006
Last updated
12/01/2020
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