Individual
DAVID W BOMBOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5630
(601) 268-5819
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5630
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
06161
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112872
—
MS
01
—
200027909
RAILROAD MEDICARE
—
01
—
640507572IS
AMERICAN ADMIN GROUP
MS
Enumeration date
07/28/2006
Last updated
08/23/2016
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