Provider Demographics
NPI:1346325149
Name:BOATRIGHT, KARL CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:CRAIG
Last Name:BOATRIGHT
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 1:40 OKATIE CENTER BLVD S.
Mailing Address - Street 2:SUITE 205 BLUFFTON-OKATIE OUTPATIENT CENTER
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909
Mailing Address - Country:US
Mailing Address - Phone:843-705-8970
Mailing Address - Fax:843-705-7034
Practice Address - Street 1:40 OKATIE CENTER BLVD S.
Practice Address - Street 2:SUITE 205 BLUFFTON-OKATIE OUTPATIENT CENTER
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-705-8970
Practice Address - Fax:843-705-7034
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC88473207X00000X
SC30979207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1264TOtherBCBS
B40644OtherMEDCOST
0956444OtherUHC
NC891264TMedicaid
SCQ00363Medicaid
200043757OtherRR MEDICARE
SCAA29028884Medicare PIN
200043757OtherRR MEDICARE
H01072Medicare UPIN
SCQ00363Medicaid
SCAA29029297Medicare PIN