Dewitt L Bolton, md
Family Medicine in Picayune, MS. Individual provider (NPI-1).
NPI number1285642330
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1285642330
- Entity type
- Individual (NPI-1)
- Name
- Dewitt L Bolton
- Credential
- md
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 4, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 05036 | MS | Yes |
Practice location
906 Sixth AvePicayune, MS 39466-3802
Phone 601-798-7529 · Fax 601-798-7553
Mailing address
906 Sixth AvePicayune, MS 39466-3802
Phone 601-798-7529 · Fax 601-798-7553
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