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309 W Church St, Greenwood, MS 38930-4305 | |
(662) 453-9004 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist |
Location | 309 W Church St, Greenwood, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962471417 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213E00000X | Podiatrist | (* (Not Available)) | Primary |
Provider Name | Preston Boles |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1699734855 PECOS PAC ID: 8224038906 Enrollment ID: I20070515000154 |
Mailing Address | Practice Location Address |
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Po Box 1410, Greenwood, MS 38935-1410 Ph: (662) 453-9004 | 309 W Church St, Greenwood, MS 38930-4305 Ph: (662) 453-9004 |
Dr. Preston Boles, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 309 W Church St, Greenwood, MS 38930 Phone: 662-453-9004 |