CHRISTOPHER GARRETT BOULLION (NPI# 1730201112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730201112 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER GARRETT BOULLION |
| Credential | D.O. |
| Practice Address |
920 Doug White Dr Ste 130 Myrtle Beach SC 29572-4120 |
| Practice Telephone | 8438481440 |
| Practice Fax Number | 8438391654 |
| Mailing Telephone | 8438481440 |
| Mailing Fax Number | 8438391654 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 1429 | SC | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 5101016197 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 01429100 | 05 |
| Street Address |
920 DOUG WHITE DR STE 130 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720063837 | Scott F Duncan V | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2005-12-12 |
| 1487294179 | Jimmy Gregory Stevens | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2020-01-09 |
| 1225686835 | Kaycee Lauren Villane | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2019-08-27 |
| 1144660986 | Jesse Marsh Putman | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2013-06-25 |
| 1427127653 | Amanda C. Barber | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2006-11-06 |
| 1235195850 | Joseph K Bethle | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4180 | 2006-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139919 | Orthosc LLC | Orthopaedic Surgery | 3620 Walton Dr Unit C-5c6, Myrtle Beach, SC 29577-6781 | 2020-09-17 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1710434451 | Carolina Orthopaedic Specialists | Orthopaedic Surgery | 185 Fresh Dr, Suite B, Myrtle Beach, SC 29579-4436 | 2016-09-09 |
| 1881727139 | Gene Matthew Massey | Orthopaedic Surgery | 210 Village Center Blvd., Suite 200, Myrtle Beach, SC 29579-6706 | 2007-03-14 |
| 1336105956 | Joe N Jarrett Jr. | Orthopaedic Surgery | 210 Village Center Blvd, Suite 200, Myrtle Beach, SC 29579-6683 | 2006-04-22 |
| 1316924632 | Carolina Bone & Joint Surgery Center | Orthopaedic Surgery | 101 Surgeons Dr, Myrtle Beach, SC 29579-5198 | 2005-12-28 |
| 1932184058 | William Paul Didelot | Orthopaedic Surgery | 920 Doug White Dr Ste 150, Myrtle Beach, SC 29572-4120 | 2005-12-13 |
| 1720063837 | Scott F Duncan V | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2005-12-12 |
| 1306347257 | Orthosc LLC | Orthopaedic Surgery | 210 Village Center Blvd Ste 200, Myrtle Beach, SC 29579 | 2018-02-26 |
| 1144660986 | Jesse Marsh Putman | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2013-06-25 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on CHRISTOPHER GARRETT BOULLION.
| 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.