| Mrs Donna Marie Bolden, MD | |
|
10777 County Road 107, Proctorville, OH 45669-8130 | |
| (740) 302-0541 | |
| Not Available |
| Full Name | Mrs Donna Marie Bolden |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 10777 County Road 107, Proctorville, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194729111 | NPI | - | NPPES |
| 3418539 | Medicaid | OH | |
| 000000550503 | Other | KY | ANTHEM BCBS |
| 00000328135 | Other | KY | ANTHEM BC/BS |
| 64066384 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 38597 (Kentucky) | Primary |
| Entity Name | Ironton & Lawrence County Area Community Action Organization |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093022287 PECOS PAC ID: 8820902497 Enrollment ID: O20031118000239 |
| Entity Name | Ironton & Lawrence County Area Community Action Organization |
|---|---|
| Entity Type | Part B Supplier - Public Health/welfare Agency |
| Entity Identifiers | NPI Number: 1215014113 PECOS PAC ID: 8820902497 Enrollment ID: O20100325000713 |
| Entity Name | Ironton & Lawrence County Area Community Action Organization |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912254574 PECOS PAC ID: 8820902497 Enrollment ID: O20130404000170 |
| Entity Name | Ironton & Lawrence County Area Community Action Organization |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770839276 PECOS PAC ID: 8820902497 Enrollment ID: O20130507000299 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Donna Marie Bolden, MD 305 N 5th St, Ironton, OH 45638-1578 Ph: (740) 532-4858 | Mrs Donna Marie Bolden, MD 10777 County Road 107, Proctorville, OH 45669-8130 Ph: (740) 302-0541 |