Individual
MADISON HANCOCK BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
818 SAINT SEBASTIAN WAY STE 400, AUGUSTA, GA 30901-2654
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
001008610
NC
363A00000X
Physician Assistant
0010-08610
NC
363A00000X
Physician Assistant
Primary
12291
GA
Other
Enumeration date
01/04/2019
Last updated
06/20/2024
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