Organization
R H BOSTWICK III OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT H BOSTWICK OD (OWNER)
(662) 534-9288
Entity
Organization
Contact information
Practice address
109 STATE HIGHWAY 15 S, NEW ALBANY, MS 38652-5206
(662) 534-9288
Mailing address
109 STATE HIGHWAY 15 S, NEW ALBANY, MS 38652-5206
(662) 534-9288
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087690
—
MS
01
—
1720265721
NPI2
MS
01
—
1821012147
NPI
MS
Enumeration date
01/22/2008
Last updated
05/19/2010
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