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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790754000 | NPPES |
| Mississippi | MEDICAID | 00113949 |
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