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General NPI Number Information
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NPI Number | 1811006174
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Entity Type | Organization
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Legal Business Name | VINCENT E. BOSWELL MD, P.C.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 285 BOULEVARD NE STE 115
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City | ATLANTA
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State | GA
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Zip | 30312-4207
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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 | 1776 PEACHTREE ST NW SUITE 318N
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City | ATLANTA
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State | GA
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Zip | 30309-2307
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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 | OWNER/PHYSICIAN
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Name | DR. VINCENT EVERETT BOSWELL
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Credential | M.D.
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Telephone | 404-588-1272
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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 | 035820
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License Number State | GA
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