Shantele H Bolton (NPI# 1629418074, PAC ID# 9931423803) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1629418074 |
| PAC ID by PECOS | 9931423803 |
| Professional Enrollment ID | I20170627002353 |
| Full Name | Shantele H Bolton |
| Organization Legal Name | WOMENS PAVILION OF SOUTH MISSISSIPPI PLLC |
| Address |
551 Eagle Day Ave Columbia MS 39429-3605 |
| Phone Number | 6012689393 |
| Gender | F |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 5799769535 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 551 Eagle Day Ave, Columbia, MS 39429-3605 | 6012689393 | WOMENS PAVILION OF SOUTH MISSISSIPPI PLLC |
| Organization Legal Name | WOMENS PAVILION OF SOUTH MISSISSIPPI PLLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eldred Wiser | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| William Pace | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 6524 U S Hwy 98, Hattiesburg, MS 39402-8569 |
| James David Ferguson | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 6524 U S Hwy 98, Hattiesburg, MS 39402-8569 |
| Andrea M Carter | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| Jana Keith | Nurse Practitioner | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| Paula F Morris | Nurse Practitioner | Womens Pavilion of South Mississippi Pllc | 6524 U S Hwy 98, Hattiesburg, MS 39402-8569 |
| Joseph T Mcintire | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| Joseph Washburne | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 6524 U S Hwy 98, Hattiesburg, MS 39402-8569 |
| Elizabeth C Washburne | Obstetrics/gynecology | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| Bridget R Cahill | Nurse Practitioner | Womens Pavilion of South Mississippi Pllc | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1331 |
| Street Address |
551 EAGLE DAY AVE |
| City | COLUMBIA |
| State | MS |
| Zip | 39429-3605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shakita D Rawls | Nurse Practitioner | Quality Medical Clinic, Inc. | 315 Lafayette St, Columbia, MS 39429-2059 |
| Vickie L Robbins | Psychologist, Clinical | Meditelecare of Mississippi LLC | 1506 N Main St, Columbia, MS 39429-2070 |
| Leonard Oswald | Clinical Social Worker | Serenity Psychiatric Outpatient, LLC | 11 Pecan Dr, Columbia, MS 39429-2600 |
| Alicia Brister | Nurse Practitioner | Internal Medicine Clinic of Columbia, P.a. | 914 Sumrall Rd, Columbia, MS 39429-2652 |
| Nancy F Easterling | Nurse Practitioner | Internal Medicine Clinic of Columbia, P.a. | 914 Sumrall Rd, Columbia, MS 39429-2652 |
| Joseph Taiwo | Emergency Medicine | Keystone Medical Services of Ms Inc | 1560 Sumrall Rd, Columbia, MS 39429-2654 |
| Oladipo Kusemiju | Family Medicine | Forrest County General Hospital | 1560 Sumrall Rd, Columbia, MS 39429-2654 |
| Ronda M Vanderheiden | Nurse Practitioner | Forrest County General Hospital | 1560 Sumrall Rd, Columbia, MS 39429-2654 |
| Lemuel D Oliver | Emergency Medicine | Keystone Medical Services of Ms Inc | 1560 Sumrall Rd, Columbia, MS 39429-2654 |
| Jackie Stuckey | Nurse Practitioner | Forrest County General Hospital | 1560 Sumrall Rd, Columbia, MS 39429-2654 |
| Find all physicians in zip 39429 | |||
| City | COLUMBIA |
| Zip Code | 39429 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | COLUMBIA + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.