Provider Demographics
NPI:1003131558
Name:BOGGS, DREXELL H (MD)
Entity Type:Individual
Prefix:
First Name:DREXELL
Middle Name:H
Last Name:BOGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 6TH AVE S
Mailing Address - Street 2:RM: 2253
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1802
Mailing Address - Country:US
Mailing Address - Phone:205-975-9399
Mailing Address - Fax:205-975-5184
Practice Address - Street 1:1700 6TH AVE S
Practice Address - Street 2:RM: 2253
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1802
Practice Address - Country:US
Practice Address - Phone:205-975-9399
Practice Address - Fax:205-975-5184
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.338082085R0001X
AL338082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology