Dr. John Bolden JR.
Infectious Disease
425 E Us Route 6
Morris
, Illinois 60450-9042
Dr. John Bolden JR.
Infectious Disease
425 E Us Route 6
Morris
, Illinois 60450-9042
(815) 941-4363
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About
Features
Specialties
- Infectious Disease
Languages spoken
- English
Location
First Address
- Dr. John Bolden JR.
- 725 School St Ste A
- Morris, IL
- Zip : 60450-1207
- Fax : (815) 941-4363
- Phone : (815) 941-9124
Second Address
- Dr. John Bolden JR.
- 425 E Us Route 6
- Morris, IL
- Zip : 60450-9042
- Fax : (815) 513-3096
- Phone : (815) 513-3074
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0200X | Infectious Disease | 036106844 | IL |
National Provider Identifier
| NPI | 1073666707 |
|---|---|
| Provider Name | Dr. John Bolden JR. |
| First Address | Morris, IL 60450-1207 |
| Second Address | Morris, IL 60450-9042 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/01/2007 |
| Last Update Date | 28/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| I28001 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.