MR. ANTHONY BRADLEY BOLAND


Address: 2500 N State St, Jackson, MS 39216-4500
Phone: 6019842680

MR. ANTHONY BRADLEY BOLAND (NPI# 1437135373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437135373
Entity Type Individual
Full Name MR. ANTHONY BRADLEY BOLAND
Credential M.D.
Practice Address 2500 N State St
Jackson
MS 39216-4500
Practice Telephone 6019842680
Practice Fax Number 6018154563
Mailing Telephone 6019842680
Mailing Fax Number 6018154563
Enumeration Date 2005-12-22
Last Update Date 2014-12-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
20979 MS Allopathic & Osteopathic Physicians
N 2086S0129X Surgery
Specialization: Vascular Surgery
MD00022869 WA Allopathic & Osteopathic Physicians
N 2086S0129X Surgery
Specialization: Vascular Surgery
044417 GA Allopathic & Osteopathic Physicians
N 2086S0129X Surgery
Specialization: Vascular Surgery
MD29549 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN PHP TENNCARE 100033107 01
TN UNITED HEALTHCARE 3740047 01
GA 00832917B 05
TN BLUECROSS OF TN 3153656 01
AETNA 4078780 01
MS RAILROAD MEDICARE PTAN P01189946 01
TN CIGNA HMO 0140040322 01
TN JOHN DEERE HEALTHCARE 62178953301 01
AL 009965915 05
FIRST HEALTH 56812 01
WA 8490567 05
MS 07188733 05
TN 3812941 05

Office Location

Street Address 2500 N STATE ST
City JACKSON
State MS
Zip Code 39216-4500

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477556231 University Ophthalmology Associates Ophthalmology 2500 N State St, Ste B329, Jackson, MS 39216-4500 2005-05-24
1396346607 Ashleigh Renfroe Hannah Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2020-11-03
1770182438 Tara P. Carter Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2020-10-22
1679189849 Raegan Wilson Registered Nurse 2500 N State St, Jackson, MS 39216-4500 2020-09-22
1851905095 Violet Maloba Awori Student in an Organized Health Care Education/Training Program 2500 N State St, Jackson, MS 39216-4500 2020-09-04
1295348639 Kassidy Voinche Pharmacist 2500 N State St, Jackson, MS 39216-4500 2020-08-25
1215549423 Brittney Leeann Williams Pharmacist 2500 N State St, Jackson, MS 39216-4500 2020-08-19
1912519364 Rashmi Verma Internal Medicine 2500 N State St, Jackson, MS 39216-4500 2020-08-18
1982215414 Anita Dhanrajani Pediatrics 2500 N State St, Jackson, MS 39216-4500 2020-08-10
1528676954 Nicholas Mcafee Psychologist 2500 N State St, Jackson, MS 39216-4500 2020-07-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861011553 Ashley Melancon Prewitt Registered Nurse St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 2020-04-13
1194353391 Brianna Arrington Student in an Organized Health Care Education/Training Program Med/ Peds, 2500 N. State St., Jackson, MS 39216 2020-04-01
1720616485 Roshina Khalid Khan Student in an Organized Health Care Education/Training Program Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 2020-03-30
1275183550 Amanda Lynn Morellato Dentist Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 2019-09-18
1396305553 Abhishek Chhabra Student in an Organized Health Care Education/Training Program Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 2019-06-19
1427615996 Hometown Diagnostics Clinical Medical Laboratory Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 2019-05-21
1346807773 Shukundala C Smith Behavior Technician New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 2019-05-21
1063901098 G Eli Howell Md Pllc Plastic Surgery 971 Lakeland Dr Ste 225, Jackson, MS 39216 2018-05-04
1588168132 Caleb Zumbro Student in an Organized Health Care Education/Training Program Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 2018-03-20
1639677230 Walgreen Co Pharmacy 971 Lakeland Dr Ste 101, Jackson, MS 39216 2018-01-29
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952557092 Medical Foundation of Central Mississippi, Inc Surgery 501 Marshall St Ste 100, Jackson, MS 39202-1687 2008-08-08
1174556377 Seshadri Raju, M.d., Pa. Surgery 971 Lakeland Dr Ste 401, Jackson, MS 39216 2006-07-09
1225575186 W.a. Foote Memorial Hospital, Inc Surgery 205 N. East Ave, Jackson, MI 49201 2017-01-30
1124565098 W.a. Foote Memorial Hospital, Inc Surgery 205 N. East Ave, Jackson, MI 49201 2017-01-30
1275893638 Derek Paul De Grijs Surgery 501 Marshall St Ste 104, Jackson, MS 39202-1663 2012-05-20
1184911612 Taimur Saleem Surgery 971 Lakeland Dr Ste 401, Jackson, MS 39216-4607 2011-07-05
1245545383 Danon Eugenio Garrido Montes De Oca Surgery 2500 N State St, Jackson, MS 39216-4500 2010-08-12
1194825323 Fred Wallace Rushton Jr. Surgery 2500 N State St, Jackson, MS 39216-4500 2006-09-25
1215960414 Seshadri Raju Surgery 971 Lakeland Dr, Suite 401, Jackson, MS 39216-4643 2006-07-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104323534 Best Vein Care of Mississippi, LLC Surgery 204 W Jackson St Ste A, Ridgeland, MS 39157-2310 2018-04-11
1457714172 Flowood Medical Management LLC Surgery 4800 Lakeland Dr, Flowood, MS 39232-8694 2016-03-30
1982009031 Magnolia General and Vascular Surgery Clinic Surgery 611 Alcorn Dr Ste 210, Corinth, MS 38834-9323 2014-10-31
1730406729 Alexander H. Nguyen Surgery 4503 M St, Biloxi, MS 39530 2010-04-29
1730243064 Frank A Nichols Surgery 1040 A So Madison, Tupelo, MS 38801 2006-12-21
1427073386 Edward E Rigdon Surgery 348 Crossgates Blvd, Suite 2500, Brandon, MS 39042-2700 2006-07-13
1790760692 Surgery Associates Pa Surgery 440 Pegram Dr, Tupelo, MS 38801-6319 2005-12-13
1396226791 North Mississippi Medical Center, Inc Surgery 616 Alcorn Dr, Corinth, MS 38834-9393 2018-08-23
1962952689 Capel Vascular Center, LLC Surgery 408 E Washington St, Greenwood, MS 38930-4539 2016-10-05
1104101575 North Mississippi Medical Center Services, LLC Surgery 607 Garfield St, Tupelo, MS 38801-6337 2011-10-18
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Competitor

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City JACKSON
Zip Code 39216

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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