Bolton, Matthew

Bolton, Matthew is an individual health care provider with primary practice located at 1503 S Main St , Crossville TN 38555-5967. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Bolton, Matthew can be contacted via phone (931) 484-6196.

Contact Information

Primary practice address
1503 S Main St Crossville TN 38555-5967
Phone: (931) 484-6196
Fax: (931) 456-1047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21614 Tennessee
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD21614 Tennessee

Profile Details

NPI number 1720082548
LBN Legal business name Bolton, Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720082548 NPPES
Tennessee Other 4129250 BCBS

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