Individual
CARL EUGENE BOSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2503 LUCY LEE PKWY, POPLAR BLUFF, MO 63901-2444
(573) 785-5544
(573) 785-4672
Mailing address
2503 LUCY LEE PKWY, POPLAR BLUFF, MO 63901-2444
(573) 785-5544
(573) 785-4672
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R8584
MO
207YX0602X
Otolaryngic Allergy Physician
R8584
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246988901
—
MO
Enumeration date
08/31/2006
Last updated
07/14/2010
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