MEDICARE: BONNIE KRISTINE BOLES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	036927	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538161492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE KRISTINE BOLES M.D.

Provider Business Mailing Address
First Line	:	119 AMBULANCE DRIVE
Second Line	:	SUITE 202
City	:	CARROLLTON
State	:	GA
Zip	:	30117-1476
Country	:	US
Telephone Number	:	770-456-3380
Fax Number	:	770-456-3785

Provider Business Practice Location Address
First Line	:	690 DALLAS HWY
Second Line	:	SUITE 207-A
City	:	VILLA RICA
State	:	GA
Zip	:	30180-1264
Country	:	US
Telephone Number	:	770-456-3380
Fax Number	:	770-456-3785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	10/11/2012

Similar Medicare Providers

1134192529 — SHERI CAMPBELL MD
Practice Location Address:

690 DALLAS HWY , SUITE 301
VILLA RICA, GA
30180-1264

Practice Phone: 770-456-3850
Practice Fax: 770-456-3826

1841265410 — JULIE WILLIARD RN FNP C
Practice Location Address:

690 DALLAS HWY , SUITE 101
VILLA RICA, GA
30180-1264

Practice Phone: 770-459-0620
Practice Fax: 770-456-7604

1558320119 — DR. WILLIAM TODD BOLEMAN MD
Practice Location Address:

690 DALLAS HWY , SUITE 101
VILLA RICA, GA
30180-1264

Practice Phone: 770-459-0620
Practice Fax: 770-456-7604

1992710750 — TMC TANNER GYNECOLOGY INC
Practice Location Address:

690 DALLAS HWY , SUITE 301
VILLA RICA, GA
30180-1264

Practice Phone: 770-456-3850
Practice Fax: 770-456-3826

1477615862 — MR. CARLOS JULIO MORENO
Practice Location Address:

690 DALLAS HWY , SUITE 101
VILLA RICA, GA
30180-1264

Practice Phone: 770-459-0620
Practice Fax: 770-456-7604

1982724811 — DR. VIRGINIA SINGER
Practice Location Address:

690 DALLAS HWY , SUITE 201
VILLA RICA, GA
30180-1264

Practice Phone: 678-840-8535
Practice Fax:

Directions to “ BONNIE KRISTINE BOLES M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.