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Individual
DR. STACY BOULTON
Active
Individual
DR. STACY BOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
40489
KY
207VG0400X
Gynecology Physician
35084722
OH
207VX0000X
Obstetrics Physician
35084722
OH
Other
Enumeration date
04/24/2006
Last updated
11/26/2007
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