Individual
NATHAN BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 BENNETT RD, OLIVER SPRINGS, TN 37840-5008
(865) 435-1933
Mailing address
103 BENNETT RD, OLIVER SPRINGS, TN 37840-5008
(865) 435-1933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64355
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q058332
—
TN
Enumeration date
03/26/2020
Last updated
06/30/2023
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