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Individual

JONELL HAMILTON BOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5000 O'DONOVAN BLVD, SUITE 404, WALKER, LA 70785-6351
(225) 271-6550
(225) 271-6551
Mailing address
5000 O'DONOVAN BLVD, SUITE 404, WALKER, LA 70785-6351
(225) 271-6550
(225) 271-6551

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
207163
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2149890
LA
Enumeration date
03/18/2011
Last updated
01/15/2021
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