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Contact Information

KENNETH BOOCKVAR, MD
619 19TH ST S
BIRMINGHAM, AL35249-6508
 Phone: 205-731-9701
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KENNETH BOOCKVAR · (Male)

NPI # 1497723845
Status Active
Credentials MD
Entity Individual
Enumeration date 03/10/2006
Last updated 06/29/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 45113
  • NY License # 1967511
  • NY Medicaid 01712138
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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