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Individual

DR. JENNIFER THOMAS BOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 TOWNCENTER BLVD, STE 201, TUSCALOUSA, AL 35406
(205) 366-9996
(205) 366-9971
Mailing address
100 TOWNCENTER BLVD, SUITE 201, TUSCALOUSA, AL 35406
(205) 366-9996
(205) 366-9971

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
19005
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000019004
AL
05
000019005
AL
01
34837
BLUE CROSS
Enumeration date
10/17/2006
Last updated
06/10/2015
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