Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 80090 | MS |
NPI | 1205049657 |
---|---|
Provider Name | Dr. Michael L Boykins |
First Address | Ridgeland, MS 39157-1254 |
Second Address | Ridgeland, MS 39157-1254 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y00126 | (02) | MS |