Bolivar Medical Clinic

NPI #1720297708 in Bolivar, Tennessee

Provider Information

NPI Number: 1720297708
Entity Type: Organization
Organization Name: Bolivar Medical Clinic
Primary Specialty: Family Medicine
Enumeration Date: May 22, 2007
Last Updated: Feb 28, 2011

Practice Location

Address: 610 NUCKOLLS RD
City: Bolivar
State: Tennessee
ZIP Code: 38008-1532
Phone: (731) 658-7111

Authorized Official

Name: DR. CHARLES L FROST, M.D.
Title: DOCTOR
Phone: (731) 658-7111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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