Bolyard, Brent

Bolyard, Brent is an sole proprietor health care provider with primary practice located at 1620 W State Highway Cc , Brighton MO 65617-9427. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Bolyard, Brent can be contacted via phone (330) 663-1583.

Contact Information

Primary practice address
1620 W State Highway Cc Brighton MO 65617-9427
Phone: (330) 663-1583
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X E-4507 Arkansas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X E-4507 Arkansas
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X E-4507 Arkansas

Profile Details

NPI number 1154341568
LBN Legal business name Bolyard, Brent
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2006
Last updated Jan 2nd, 2017 - about 8 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 1154341568 NPPES
Arkansas MEDICAID 158495001

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