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

Mr. Charles Edward Bouldin, RPT

Individual provider Specialist · NPI 1679690101

Mr. Charles Edward Bouldin, RPT is a Physical Therapist in Private Practice in Tupelo, Mississippi. Qualified in 1976, 50 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
50
Licensed in
MS
In the registry since
2007
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Practice location Address checks out

4749 S Eason Blvd Ste A
Tupelo, MS 38801-6547
Phone: (662) 842-3336
Fax: (662) 842-3363
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence PT0198 (MS)

Record details

NPI number1679690101
Entity typeIndividual (Type 1)
GenderMale
Credentials RPT
Sole proprietorYes
NPI enumeratedMarch 22, 2007
Last updated in NPPESNovember 8, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1976 (50 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tupelo