Individual
KIRSTEN J BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2781 HIGHWAY 145, SALTILLO, MS 38866-9783
(662) 869-0033
(662) 869-0053
Mailing address
PO BOX 1308, SALTILLO, MS 38866-1308
(662) 869-0033
(662) 869-0053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16344
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120764
—
MS
Enumeration date
07/20/2006
Last updated
01/22/2020
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