Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD31576 | AL |
NPI | 1245551878 |
---|---|
Provider Name | Scott C Boyken |
First Address | Pell City, AL 35125-9314 |
Second Address | Trussville, AL 35173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 30/08/2018 |