Individual
BRENT L BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33921
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350677
ANTHEM / NMA
—
01
—
000052154B
HUMANA / NMA
—
01
—
012961
SIHO / NMA
—
01
—
1171473
PASSPORT / NMA
—
01
—
1183574
CHA / NMA
—
01
—
2440810000
PASSPORT ADVANTAGE
—
05
—
64012024
—
KY
01
—
9034053002
CIGNA / NMA
—
Enumeration date
04/18/2006
Last updated
07/09/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us