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BOLTON CLINIC PLLC NPI 1851429971


NPI Information

NPI: 1851429971
Provider Name: BOLTON CLINIC, PLLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
2001 AIRPORT RD N
SUITE 204
FLOWOOD, MS
ZIP 39232
Phone: (601) 932-3191
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BOLTON CLINIC, PLLC is a family nurse practitioner in Flowood, MS. BOLTON CLINIC, PLLC NPI is 1851429971. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2001 AIRPORT RD N
SUITE 204
FLOWOOD, MS
ZIP 39232-827
Phone: (601) 932-3191
Fax: (601) 936-7193

The provider's authorized official is William F Krooss .
The authorized official title is Managing Member and has the following contact phone number (601) 932-3191.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 4/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyR652075MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1253891MEDICARE OSCAR/CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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