Individual
DAVID WESLEY BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
856 1ST ST, MACON, GA 31201-6875
(478) 741-1740
(478) 745-2887
Mailing address
8043 RIVOLI RD UNIT 428, BOLINGBROKE, GA 31004-3019
(478) 744-1710
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
02003130A
IN
207W00000X
Ophthalmology Physician
043122
CT
207W00000X
Ophthalmology Physician
3936
OK
207W00000X
Ophthalmology Physician
Primary
73540
GA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
73540
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000495130
ANTHEM
—
05
—
200838980
—
IN
Enumeration date
11/26/2005
Last updated
01/28/2019
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