Individual
PATRICK LYNN BOLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 HIGHWAY 80 E, CLINTON, MS 39056-5252
(601) 910-3004
Mailing address
815 HIGHWAY 80 E, CLINTON, MS 39056-5252
(601) 910-3004
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24316
MS
207N00000X
Dermatology Physician
PGY..202111
LA
207R00000X
Internal Medicine Physician
LL34725
SC
Other
Enumeration date
06/12/2012
Last updated
07/14/2016
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