Individual
DR. DAVID L BOLES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1011 HIGHWAY 76 STE A, CLARKSVILLE, TN 37043-2531
(931) 245-1150
(931) 245-0605
Mailing address
PO BOX 30459, CLARKSVILLE, TN 37040
(931) 245-1150
(931) 245-0605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO647
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3391811
—
TN
Enumeration date
08/11/2006
Last updated
12/10/2012
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