DR. MARK EDWIN BOLTON


Address: 2116 W Faidley Ave., Department of Radiation Therapy, Grand Island, NE 68802-9804
Phone: 3083985450

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0203X Radiology
Specialization: Therapeutic Radiology
18773 NE Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NE 10025024800 05

Other Providers MARK BOLTON

NPI Name Taxonomy Address Enumeration
1790785152 Mark James Bolton Emergency Medicine 420 N James Rd, Columbus, OH 43219-1834 2005-07-28

Office Location

Street Address 2116 W FAIDLEY AVE.
DEPARTMENT OF RADIATION THERAPY
City GRAND ISLAND
State NE
Zip Code 68802-9804

Providers in the same zip code

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 Information

Taxonomy Code 2085R0203X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Therapeutic Radiology

Taxonomy Definition

Definition to come...

Competitor

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City GRAND ISLAND
Zip Code 68802

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Dataset Information

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.

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