Provider Demographics
NPI:1306904198
Name:BOYKIN, DONOVAN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:LEE
Last Name:BOYKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-0730
Mailing Address - Country:US
Mailing Address - Phone:303-646-0893
Mailing Address - Fax:303-646-0888
Practice Address - Street 1:350 WEST KIOWA AVE.
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107
Practice Address - Country:US
Practice Address - Phone:303-646-0893
Practice Address - Fax:303-646-0888
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0004046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC460968Medicare ID - Type Unspecified