Organization
BOLTON FAMILY MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRSTEN J BOLTON M.D. (PRESIDENT/PHYSICIAN)
(662) 869-0033
Entity
Organization
Contact information
Practice address
2781 HIGHWAY 145, SALTILLO, MS 38866-9783
(662) 869-0033
(662) 869-0053
Mailing address
PO BOX 1308, SALTILLO, MS 38866-1308
(662) 869-0033
(662) 869-0053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16344
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09623207
—
MS
Enumeration date
11/21/2007
Last updated
01/10/2014
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