Individual
JOHN CRAIG BOLLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6267
(608) 826-2710
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6267
(608) 826-2710
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
19952
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30624300
—
WI
Enumeration date
08/25/2006
Last updated
07/08/2007
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