Jerry D. Boggs
Neurologist
1741 West Harvard Ave
Roseburg
, Oregon 97471-2716
Jerry D. Boggs
Neurologist
1741 West Harvard Ave
Roseburg
, Oregon 97471-2716
(541) 440-5322
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Jerry D. Boggs
- Po Box 1700
- Roseburg, OR
- Zip : 97470-0414
- Fax : (541) 440-5322
- Phone : (541) 440-5320
Second Address
- Jerry D. Boggs
- 1741 West Harvard Ave
- Roseburg, OR
- Zip : 97471-2716
- Fax : (541) 440-5322
- Phone : (541) 440-5320
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | MD20969 | OR |
National Provider Identifier
| NPI | 1003890153 |
|---|---|
| Provider Name | Jerry D. Boggs |
| First Address | Roseburg, OR 97470-0414 |
| Second Address | Roseburg, OR 97471-2716 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/12/2005 |
| Last Update Date | 10/09/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 151137 | (05) | OR |
| G68914 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.