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General NPI Number Information
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NPI Number | 1336138544
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Entity Type | Individual
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Provider Name | JOHN A BOLINGER DO
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 1606 N 7TH STREET UNION HOSPITAL
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City | TERRE HAUTE
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State | IN
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Zip | 47804-2780
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Country | US
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Telephone | 812-238-4644
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Fax | 812-238-7837
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Provider Business Mailing Address
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Address Line | 6898 N COUNTY ROAD 375 W
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City | BRAZIL
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State | IN
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Zip | 47834-7262
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Country | US
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Telephone | 812-448-1701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02001231A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 02001231A
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License Number State | IN
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