Organization
BOLES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN DOVEL BOLES MD (CEO)
(226) 265-1323
Entity
Organization
Contact information
Practice address
4500 13TH ST STE 900, GULFPORT, MS 39501-2515
(225) 822-6965
(226) 822-6999
Mailing address
2194 HARMANSON VUE, BILOXI, MS 39531-5273
(226) 236-3872
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
12/11/2023
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