Provider Demographics
NPI:1679630602
Name:SINGLETON, BOLYNTHIA DENISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BOLYNTHIA
Middle Name:DENISE
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:BOLYNTHIA
Other - Middle Name:DENISE
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSRRT
Mailing Address - Street 1:2616 BRITTANY PARK LN
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6275
Mailing Address - Country:US
Mailing Address - Phone:404-274-7314
Mailing Address - Fax:
Practice Address - Street 1:THE WOUND PROS
Practice Address - Street 2:4640 ADMIRALTY WAY SUITE 500
Practice Address - City:MARINA DEL RAY
Practice Address - State:CA
Practice Address - Zip Code:90292
Practice Address - Country:US
Practice Address - Phone:888-880-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005198363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical