MARSHALL J. BOULDIN, IV M.D. – NPI #1255364956
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

MARSHALL BOULDIN, IV is a physician located in JACKSON, MS. NPPES has assigned the NPI number 1255364956 to MARSHALL BOULDIN, IV on July 08, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 12 years ago on Mar 09, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARSHALL BOULDIN, IV below.

NPI Profile for
MARSHALL J. BOULDIN, IV

NPI Number
1255364956
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MARSHALL J. BOULDIN, IV
Credentials
M.D.
Primary location
1040 RIVER OAKS DR
SUITE 302
JACKSON, MS 39232-9530
Phone: (601) 939-9923 Fax: (601) 939-9924
Mailing address
3322 W END AVE
11TH FLOOR
NASHVILLE, TN 37203-1031
Phone: (615) 515-9880 Fax:
Sole Proprietor
No
Updated
Identifiers

Identifiers for MARSHALL BOULDIN, IV

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERRAILROADMSRR 110204015
MEDICAIDMS00120235
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
MS 12970

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.