Organization
MICHAEL T. BOLER, M.D.
Active
Parent organization
MICHAEL T. BOLER, M.D.
Other names
Michael T. Boler, M.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL T. BOLER, M.D.
Authorized official
DR. MICHAEL BOLER SR. MD (MD)
(662) 453-5331
Entity
Organization
Contact information
Practice address
201 WALTHALL ST, GREENWOOD, MS 38930-4428
(662) 453-5331
(662) 453-5332
Mailing address
PO BOX 550, GREENWOOD, MS 38935-0550
(662) 453-5331
(662) 453-5332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821071267
NPI
—
Enumeration date
01/28/2021
Last updated
01/28/2021
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