Randall J. Bolar, MD, PLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34949 Issued in TN

Legal business name

RANDALL J. BOLAR, MD, PLC

Practice address

787 Weatherly Dr
Suite 400
Clarksville, TN 37043-8949

Phone

(931) 552-0380

Fax

(931) 551-3157

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Randall J Bolar, M.D.

Title

Sole Member

Phone

(931) 552-0380

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1316973522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 WEATHERLY DR",
            "address_2": "SUITE 400",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438949",
            "telephone_number": "931-552-0380",
            "fax_number": "931-551-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 WEATHERLY DR",
            "address_2": "SUITE 400",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438949",
            "telephone_number": "931-552-0380",
            "fax_number": "931-551-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL J. BOLAR, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "BOLAR",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "931-552-0380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "34949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raintree Counseling PLLC
• Peter P. Rajtar, M.D.
• Destiny Ramey
• Haley Grace Ramirez
• Nelson Ramos Jr., RN
• Holly Ann Randle, RN
• Anita Randolph, LPS/MHSP
• Ashley Elizabeth Randolph
• Alyssa Rangel
• Oscar Lane Rankin Jr., D. D. S.

• Surgery Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.