Eric L Bosley, M.D.
Individual provider Active NPI Pediatrics Physician · Crestview Hills, KY
NPI 1295717064 · NPPES record last updated Nov 20, 2016
Key facts
- NPI
- 1295717064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 34830 (KY)
- Practice address
- 2865 Chancellor Dr
Suite 225
Crestview Hills, KY 41017-3912 - Phone
- (859) 341-5400
- Fax
- (859) 578-3172
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34830 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates PSC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- ebosley@pedassocsky.opdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 34830 | KY | Yes |
Addresses
Primary practice location
2865 Chancellor Dr
Suite 225
Crestview Hills, KY 41017-3912
Mailing address
2865 Chancellor Dr
Suite 225
Crestview Hills, KY 41017-3912
Phone (859) 341-5400
Other providers in Crestview Hills, KY
- Heather Marie Birk
- Alissa Bishop
- Valery R Bodziony
- Bogner & Carr, Inc.
- Christopher F Bolling
- Michelle M Bosse
- Shannon Bowen
- Brace Shop & Prosthetic Services Inc
- Emily Nichole Bray
- Grant Hamilton Breazeale
All providers in Crestview Hills, KY · Pediatrics Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.