Individual
MARY L BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
460 SPRING ST, JEFFERSONVILLE, IN 47130-3452
(812) 280-2080
Mailing address
1913 DILLON DR, LOUISVILLE, KY 40205-2803
(812) 280-2080
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01040813A
IN
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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