Kyskie Bolton, RD | |
17280 Highway 17, Lexington, MS 39095-6614 | |
(662) 834-1857 | |
(662) 834-1859 |
Full Name | Kyskie Bolton |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 17280 Highway 17, Lexington, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396987376 | NPI | - | NPPES |
06381069 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | D1245 (Mississippi) | Primary |
Provider Name | G A Carmichael Family Health Center Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1801952809 PECOS PAC ID: 2567371032 Enrollment ID: O20050816001055 |
Provider Name | H E A L Mississippi |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1710659453 PECOS PAC ID: 5496142036 Enrollment ID: O20220428001468 |
Mailing Address | Practice Location Address |
---|---|
Kyskie Bolton, RD 1668 W Peace St, Canton, MS 39046-5332 Ph: (601) 859-5213 | Kyskie Bolton, RD 17280 Highway 17, Lexington, MS 39095-6614 Ph: (662) 834-1857 |
Amber Fly Westbrooks, L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 | |
Edith Wade, L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17 South, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |
Lindsay Taylor, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-1859 | |
Angelee B Mayo, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 | |
Marven Denis Cantave, RD Dietitian Medicare: Medicare Enrolled Practice Location: 208 Court Sq, Lexington, MS 39095 Phone: 216-633-8189 | |
Mnt Delta Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 208 Court Sq, Lexington, MS 39095 Phone: 216-633-8189 |