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1245812320
DERRICK PAUL BOULDIN
FORT CAMPBELL, KY
NPI
1245812320
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-04-27
Last Update Date
2021-04-27
Business Address
Mr. DERRICK PAUL BOULDIN PA-C
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8400
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Mailing Address
Mr. DERRICK PAUL BOULDIN PA-C
109 MILL WALK CT
MADISON, AL 35758-1508
Phone number:
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