Boulware, Frederick Thornton
Boulware, Frederick Thornton is an individual health care provider with primary practice located at 2423 W Dunlap Ave Ste 130, Phoenix AZ 85021-5818. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neuromuscular Medicine. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Boulware, Frederick Thornton can be contacted via phone (602) 424-4450.Contact Information
Primary practice address
2423 W Dunlap Ave Ste 130
Phoenix AZ 85021-5818
Phone: (602) 424-4450
Fax: (602) 424-4451
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 37701 | Arizona |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | 37701 | Arizona |
| Allopathic & Osteopathic Physicians / Neuromuscular Medicine | 2084N0008X | 37701 | Arizona |
Profile Details
| NPI number | 1497733174 |
|---|---|
| LBN Legal business name | Boulware, Frederick Thornton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Sep 18th, 2012 - about 12 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 | 1497733174 | NPPES |
| Nevada | MEDICAID | 002002038 | |
| Nevada | MEDICAID | 100500484 |
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