Dr. Travis L Bolton Jr., M.D.
Hospitalist in Rio Rancho, NM. Individual provider (NPI-1).
NPI number1932184181
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1932184181
- Entity type
- Individual (NPI-1)
- Name
- Dr. Travis L Bolton Jr.
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2005
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | MD2017-0672 | NM | Yes |
| 207R00000X | Internal Medicine | MD2017-0672 | NM |
Practice location
2400 Unser Blvd SeRio Rancho, NM 87124-4740
Phone 505-253-1187 · Fax 505-253-1199
Mailing address
5410 Maryland Way Ste 300Brentwood, TN 37027-5339
Phone 615-371-5778 · Fax 615-290-5294
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