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General NPI Number Information
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NPI Number | 1609865021
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Entity Type | Individual
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Provider Name | VINCENT EVERETT BOSWELL M.D., P.C.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 285 BOULEVARD NE SUITE 115
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City | ATLANTA
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State | GA
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Zip | 30312-4205
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Country | US
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Telephone | 404-588-1272
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Fax | 404-588-1275
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Provider Business Mailing Address
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Address Line | 285 BOULEVARD NE SUITE 115
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City | ATLANTA
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State | GA
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Zip | 30312-4205
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Country | US
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Telephone | 404-588-1272
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Fax | 404-588-1275
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0-35820
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License Number State | GA
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