Boller, Alex R

Boller, Alex R is an individual health care provider with primary practice located at 301 Hiwassee Community Dr. , Madisonville TN 37354. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Family Medicine. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Boller, Alex R can be contacted via phone (423) 436-7730.

Contact Information

Primary practice address
301 Hiwassee Community Dr. Madisonville TN 37354
Phone: (423) 436-7730
Fax: (423) 436-0384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA-001385-L Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4902 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004090 New York

Profile Details

NPI number 1568449205
LBN Legal business name Boller, Alex R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Mar 7th, 2023 - about 2 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 1568449205 NPPES
Other 910248 NCCPA #
Other 004090 NCCPA #
Other MA-001385-L NCCPA #

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