Individual
DR. KELLY LEIGH BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DIV IM BONE MARROW TRANSPLANT, SAINT LOUIS, MO 63110-1003
(314) 454-8304
(314) 454-5902
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-8304
(314) 454-5902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2020041309
MO
207RX0202X
Medical Oncology Physician
Primary
2020041309
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200092603
—
MO
Enumeration date
05/03/2013
Last updated
04/15/2025
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