Boldon, Billy

Boldon, Billy is an individual health care provider with primary practice located at 1405 Strong Ave , Greenwood MS 38930-4035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Boldon, Billy can be contacted via phone (662) 459-7030.

Contact Information

Primary practice address
1405 Strong Ave Greenwood MS 38930-4035
Phone: (662) 459-7030
Fax: (662) 459-1104
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 12903 Mississippi

Profile Details

NPI number 1790754000
LBN Legal business name Boldon, Billy
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Apr 25th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790754000 NPPES
Mississippi MEDICAID 00113949

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