# WILLIAM R BOULDEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1609830355
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 19337 | IA | Yes |

## Other

- **Enumeration date:** 04/12/2006
- **Last updated:** 01/22/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2138891 | — | IA |
| 01 | — | 50215 | BLUE CROSS BLUE SHIELD | — |
| 01 | — | P00060888 | RAILROAD MEDICARE | IA |