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Individual

MS. LINDA LEIGH BOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2123 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 721-7373
(513) 977-4253
Mailing address
237 WILLIAM HOWARD TAFT RD, 2ND FL, CBO2-3, ATTN: CREDENTIALING, CINCINNATI, OH 45219-2610
(513) 263-8571
(513) 366-4480

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50-002525
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0083895
MEDICAID
OH
01
1629602
GATEWAY HEALTH
OH
01
270577733085
CARESOURCE
OH
01
790384
ANTHEM
OH
01
9670571
AETNA
OH
01
H140240
MEDICARE
OH
01
P01238519
RAILROAD MEDICARE
OH
01
P10000899676
BUCKEYE
OH
Enumeration date
03/29/2007
Last updated
02/10/2015
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