# MICHAEL T. BOLER, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHAEL T. BOLER, M.D.
- **Other names:** Michael T. Boler, M.D.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225629678
- **Legal business name:** MICHAEL T. BOLER, M.D.
- **Authorized official:** DR. MICHAEL BOLER SR. MD (MD)
- **Authorized official phone:** (662) 453-5331

## Contact information

- **Practice address:** 201 WALTHALL ST, GREENWOOD, MS 38930-4428
- **Practice address phone:** (662) 453-5331
- **Practice address fax:** (662) 453-5332
- **Mailing address:** PO BOX 550, GREENWOOD, MS 38935-0550
- **Mailing address phone:** (662) 453-5331
- **Mailing address fax:** (662) 453-5332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/28/2021
- **Last updated:** 01/28/2021