Organization
WILLIAM R. BOULDEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ROGER BOULDEN MD (PRESIDENT)
(515) 440-2676
Entity
Organization
Contact information
Practice address
12499 UNIVERSITY AVE, SUITE 210, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Mailing address
12499 UNIVERSITY AVE, SUITE 201, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19337
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50215
WELLMARK BLUE SHIELD
IA
01
—
CR0838
RAILROAD MEDICARE
IA
Enumeration date
04/25/2007
Last updated
11/30/2009
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