Provider Demographics
NPI:1487724381
Name:BOYKIN-WRIGHT, CARMEL ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEL
Middle Name:ROSE
Last Name:BOYKIN-WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 N HANLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-2003
Mailing Address - Country:US
Mailing Address - Phone:314-615-0600
Mailing Address - Fax:314-615-8303
Practice Address - Street 1:6121 N HANLEY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-2003
Practice Address - Country:US
Practice Address - Phone:314-615-0600
Practice Address - Fax:314-615-8303
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF64760Medicare UPIN