Bolin, John A

Bolin, John A is an individual health care provider with primary practice located at 4630 Ambassador Caffery Pkwy Ste 406, Lafayette LA 70508-6949. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bolin, John A can be contacted via phone (337) 989-8770.

Contact Information

Primary practice address
4630 Ambassador Caffery Pkwy Ste 406 Lafayette LA 70508-6949
Fax: (337) 989-8768
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 010571 Louisiana

Profile Details

NPI number 1205811643
LBN Legal business name Bolin, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Jul 9th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205811643 NPPES
Louisiana MEDICAID 1442291
Louisiana MEDICAID 1119491

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