GARY BRONSON BUBBA BOGGS AGACNP NPI 1194219584

NPI Information

Gary Bronson Bubba Boggs, AGACNP is an acute care nurse practitioner in Mccomb, MS with 6 years of experience. Gary Bronson Bubba Boggs, AGACNP NPI is 1194219584. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

215 MARION AVE
MCCOMB, MS
ZIP 39648-705
Phone: (601) 249-5500

The NPI 1194219584 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/19/2018 and was last updated on 9/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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