Boland, Anthony Bradley

Boland, Anthony Bradley is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Boland, Anthony Bradley can be contacted via phone (601) 984-2680.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-2680
Fax: (601) 815-4563
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD29549 Tennessee
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 044417 Georgia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD00022869 Washington
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 20979 Mississippi

Profile Details

NPI number 1437135373
LBN Legal business name Boland, Anthony Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Dec 3rd, 2014 - about 11 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 1437135373 NPPES
Mississippi MEDICAID 07188733
Mississippi Other 100033107
Mississippi Other 4078780
Mississippi Other 3153656
Mississippi Other 62178953301
Mississippi Other 0140040322
Mississippi Other 3740047
Mississippi MEDICAID 00832917B
Mississippi MEDICAID 009965915
Mississippi Other 56812
Mississippi Other P01189946
Mississippi MEDICAID 3812941
Mississippi MEDICAID 8490567

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