Provider Demographics
NPI:1396753356
Name:BOGER, WILLIAM G (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:BOGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5326 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2411
Mailing Address - Country:US
Mailing Address - Phone:931-451-7946
Mailing Address - Fax:931-451-7934
Practice Address - Street 1:2000 RESERVE BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2370
Practice Address - Country:US
Practice Address - Phone:931-486-4200
Practice Address - Fax:931-486-4209
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN35465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523993Medicaid
0527790OtherCIGNA HMO
0527790OtherCIGNA PPO
4080500OtherBLUE CROSS NETWORK K
H45337Medicare UPIN
TN3867208Medicare ID - Type Unspecified
H45337OtherHEALTHSPRING HMO
4080500OtherBLUE CROSS NETWORK C
TN3867208Medicaid
7497274OtherAETNA
4080500OtherBLUE CROSS NETWORK P
4080500OtherBLUE CROSS NETWORK S