Carl Eugene Bosley, D.O.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

R8584 Issued in MO

Practice address

2503 Lucy Lee Pkwy
Poplar Bluff, MO 63901-2444

Phone

(573) 785-5544

Fax

(573) 785-4672

NPI assigned

Aug 31, 2006

Last updated

Jul 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Otolaryngology

  NPD (past)
• Poplar Bluff Hma Physician Management, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1598710147
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1942312921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012444",
            "telephone_number": "573-785-5544",
            "fax_number": "573-785-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012444",
            "telephone_number": "573-785-5544",
            "fax_number": "573-785-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "CARL",
        "middle_name": "EUGENE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "R8584",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MO",
            "license": "R8584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246988901",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Elaine Boles
• Chelsea Bolin, LCSW
• John Bollenbacher, CRNA
• Wendy N Boone
• Timberlee Lynne Booth
• Roger Kingsley Bost, MD
• Kyle Demetri Bounds
• Jacob Bowen, PHARMD
• Connie Bowens, PN
• Christian Bowers, APRN

• Otolaryngology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.