DR. MARK EDWIN BOLTON (NPI# 1902999592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902999592 |
Entity Type | Individual |
Full Name | DR. MARK EDWIN BOLTON |
Credential | PH.D., M.D. |
Practice Address |
2116 W Faidley Ave. Department of Radiation Therapy Grand Island NE 68802-9804 |
Practice Telephone | 3083985450 |
Practice Fax Number | 3083985351 |
Mailing Telephone | 3083985450 |
Mailing Fax Number | 3083985351 |
Enumeration Date | 2006-10-02 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
18773 | NE | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NE | 10025024800 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790785152 | Mark James Bolton | Emergency Medicine | 420 N James Rd, Columbus, OH 43219-1834 | 2005-07-28 |
Street Address |
2116 W FAIDLEY AVE. DEPARTMENT OF RADIATION THERAPY |
City | GRAND ISLAND |
State | NE |
Zip Code | 68802-9804 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275026312 | Abbie Kelley | Licensed Practical Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-06-13 |
1831205152 | Orthopaedic Surgicenter Inc | Clinic/Center | 810 Diers Avenue, Suite A, Grand Island, NE 68802 | 2006-08-21 |
1336187905 | Elizabeth Ann Heidt Kozisek | Psychologist | 1932 Aspen Circle, Suite J, Grand Island, NE 68802 | 2006-06-03 |
1932191301 | Jennifer Mcclure | Physical Therapist | West Faidley Medical Center, 620 N. Diers, Suite 300, Grand Island, NE 68802 | 2005-08-22 |
1396226668 | Dawn Lutz | Licensed Practical Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-08-24 |
1104307461 | Kim Woitaszewski | Registered Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-08-24 |
1154816049 | Jennifer Nowicki | Registered Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-06-25 |
1033603386 | Monti Starkey | Licensed Practical Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-06-20 |
1649764226 | Kellie Brittain | Licensed Practical Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-06-18 |
1518450469 | Delynn Karr | Licensed Practical Nurse | 123 S. Webb Rd., Grand Island, NE 68802 | 2018-06-14 |
Find all providers in zip 68802 |
Taxonomy Code | 2085R0203X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Therapeutic Radiology |
Definition to come... |
City | GRAND ISLAND |
Zip Code | 68802 |
Please comment or provide details below to improve the information on DR. MARK EDWIN BOLTON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.