Dr Douglas Bolda, MD | |
1263 Hospital Dr Nw Ste 105, Corydon, IN 47112-2173 | |
(812) 738-4251 | |
Not Available |
Full Name | Dr Douglas Bolda |
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Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 1263 Hospital Dr Nw Ste 105, Corydon, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174519458 | NPI | - | NPPES |
200804530 | Medicaid | IN | |
1174519458 | Medicaid | WI | |
000000391438 | Other | IN | ANTHEM, BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 77087 (Wisconsin) | Secondary |
207X00000X | Orthopaedic Surgery | 01048624A (Indiana) | Primary |
Entity Name | Franciscan Physician Network |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486 |
Mailing Address | Practice Location Address |
---|---|
Dr Douglas Bolda, MD Po Box 38, Corydon, IN 47112-0038 Ph: (812) 738-4251 | Dr Douglas Bolda, MD 1263 Hospital Dr Nw Ste 105, Corydon, IN 47112-2173 Ph: (812) 738-4251 |
Dr. Kevin Andrew Kline, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1263 Hospital Dr Nw, Suite 105, Corydon, IN 47112 Phone: 812-734-3800 Fax: 812-734-3108 | |
Mr. Kenneth J Renner, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1263 Hospital Dr Nw, Suite 105, Corydon, IN 47112 Phone: 812-734-3800 Fax: 812-734-3801 |