| Larry T. Bolton, M.d.,p.c. | |
|
303 Parks Ave Scottsboro AL 35768-2411 | |
| (256) 574-3623 | |
| (256) 574-6223 |
| Full Name | Larry T. Bolton, M.d.,p.c. |
|---|---|
| Speciality | General Practice |
| Location | 303 Parks Ave, Scottsboro, Alabama |
| Authorized Official Name and Position | Larry T Bolton (OWNER) |
| Authorized Official Contact | 2565743623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry T. Bolton, M.d.,p.c. 303 Parks Ave Scottsboro AL 35768-2411 Ph: (256) 574-3623 | Larry T. Bolton, M.d.,p.c. 303 Parks Ave Scottsboro AL 35768-2411 Ph: (256) 574-3623 |
| NPI Number | 1104133495 |
|---|---|
| Provider Enumeration Date | 09/08/2010 |
| Last Update Date | 09/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104133495 | NPI | - | NPPES |
| 000000569 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 5951 (Alabama) | Primary |
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