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General NPI Number Information
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NPI Number | 1770441248
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Entity Type | Organization
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Legal Business Name | BOATOX LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 113 W JACKSON ST STE 1A
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City | RIDGELAND
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State | MS
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Zip | 39157-2401
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Country | US
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Telephone | 601-863-9663
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Fax | 855-343-5763
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Provider Business Mailing Address
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Address Line | 24898 ROUTE W40
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City | BONAPARTE
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State | IA
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Zip | 52620-8142
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Country | US
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Telephone | 903-571-3844
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Fax | 855-343-5763
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Authorized Official
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Title or Position | REVENUE CYCLE ADMIN
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Name | TERESA GREEN
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Credential |
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Telephone | 903-571-3844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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