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NPI Code Detail

MEDICARE: ZACHARY O BOSLEY D.O.

MEDICARE: ZACHARY O BOSLEY D.O.
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
1207R00000XInternal Medicine Physician3219WV

Other Identifiers

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

General Provider Information

NPI Number : 1952717571
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY O BOSLEY D.O.
Provider Business Mailing Address
First Line : 90 JACKSON PIKE
Second Line :
City : GALLIPOLIS
State : OH
Zip : 45631
Country : US
Telephone Number : 304-675-4498
Fax Number : 304-675-2103
Provider Business Practice Location Address
First Line : 2605 JACKSON AVE
Second Line :
City : POINT PLEASANT
State : WV
Zip : 25550-1615
Country : US
Telephone Number : 855-446-5937
Fax Number : 304-675-2103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2014
Last Update Date : 11/25/2020

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Directions to “ ZACHARY O BOSLEY D.O.” Practice Location

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