Provider Demographics
NPI:1265522544
Name:BOYKIN, DARRELL J (MD)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:J
Last Name:BOYKIN
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 1:300 E MCBEE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-2286
Mailing Address - Fax:
Practice Address - Street 1:240 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8013
Practice Address - Country:US
Practice Address - Phone:803-708-8126
Practice Address - Fax:803-708-1370
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12954207L00000X, 207LP2900X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC050028867OtherRR MEDICARE
SC4131524OtherAETNA
SC129549Medicaid
SC77780OtherMEDCOST
SC2000949OtherCCP
SC129549OtherSELECT HEALTH
SC2000949OtherCCP
SC4131524OtherAETNA