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Individual

DAVID L BOLLIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
333 N 14TH ST, WAKEENEY, KS 67672-3000
(785) 743-2124
Mailing address
318 N 8TH, WAKEENEY, KS 67672

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0421431
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
105875
BCBS - WFCC
KS
01
105876
BCBS - EFCC
KS
Enumeration date
10/12/2006
Last updated
07/09/2007
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