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Contact Information

ANTHONY B BOLAND, MD
2500 N STATE ST
JACKSON, MS39216-4500
 Phone: 601-984-2680
 Fax: 601-815-4563
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for ANTHONY B BOLAND · (Male)

NPI # 1437135373
Status Active
Credentials MD
Entity Individual
Enumeration date 12/22/2005
Last updated 12/03/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 044417
  • MS License # 20979
  • TN License # MD29549
  • WA License # MD00022869
  • AL Medicaid 009965915
  • GA Medicaid 00832917B
  • MS Medicaid 07188733
  • TN Medicaid 3812941
  • WA Medicaid 8490567
  • Other 4078780 AETNA
  • Other 56812 FIRST HEALTH
  • MS Other P01189946 RAILROAD MEDICARE PTAN
  • TN Other 3153656 BLUECROSS OF TN
  • TN Other 0140040322 CIGNA HMO
  • TN Other 62178953301 JOHN DEERE HEALTHCARE
  • TN Other 100033107 PHP TENNCARE
  • TN Other 3740047 UNITED HEALTHCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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