Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Richard C Boleware, CP

Individual provider Prosthetist · NPI 1194909069

Mr. Richard C Boleware, CP is a Prosthetist in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007

Practice location Address checks out

2 Old River Pl Ste D
Jackson, MS 39202-3435
Phone: (601) 944-1130
Fax: (601) 355-7476
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetist (primary) Taxonomy 224P00000X · Licence CP003226 (MS)

Record details

NPI number1194909069
Entity typeIndividual (Type 1)
GenderMale
Credentials CP
Sole proprietorNo
NPI enumeratedDecember 27, 2007
Last updated in NPPESMay 19, 2015

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