Provider Demographics
NPI:1457618357
Name:BOATRIGHT, JEFFREY DAVID
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:BOATRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 SPRINGHILL MEMORIAL DR N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1162
Mailing Address - Country:US
Mailing Address - Phone:251-410-3600
Mailing Address - Fax:251-410-3700
Practice Address - Street 1:3610 SPRINGHILL MEMORIAL DR N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-410-3600
Practice Address - Fax:251-410-3700
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL37412207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program