David W Bomboy, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

06161 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Phone

(601) 268-5630

Fax

(601) 268-5819

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1033123716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5630",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5630",
            "fax_number": "601-268-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBOY",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "06161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572IS",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200027909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112872",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimneesha Bolton
• Lacetria Bolton
• Mary Darlene Bolton, FNP-BC
• Matthew Dane Bolton, CNP
• Shantele Hinton Bolton, M.D.
• Christopher Lamar Bond, DNP, CRNA
• Garrett Cole Bond, AG-ACNP
• Molly Bonds
• Camille Elizabeth Bondurant, MS, LPC-S
• Sheri M Boney, FNP

• Orthopaedic Surgery Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Orthopaedic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.