| Boles LLC | |
|
4500 13th St Ste 900 Gulfport MS 39501-2515 | |
| (225) 822-6965 | |
| (226) 822-6999 |
| Full Name | Boles LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4500 13th St Ste 900, Gulfport, Mississippi |
| Authorized Official Name and Position | Nathan Dovel Boles (CEO) |
| Authorized Official Contact | 2282363872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boles LLC 1302 44th Ave Gulfport MS 39501-2552 Ph: (226) 236-3872 | Boles LLC 4500 13th St Ste 900 Gulfport MS 39501-2515 Ph: (225) 822-6965 |
| NPI Number | 1841790367 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 09/08/2026 |
| Certification Date | 09/08/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841790367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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