Individual
MICHAEL TODD BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8200 CONSTANTIN BLVD FL 4, BATON ROUGE, LA 70809-3481
(225) 765-5500
(225) 765-1202
Mailing address
7777 HENNESSY BLVD, SUITE 502, BATON ROUGE, LA 70808-4300
(225) 765-6834
(225) 765-1202
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD.200870
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04953094
—
MS
05
—
1071871
—
LA
Enumeration date
05/23/2007
Last updated
01/18/2021
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