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Contact Information

GREG H BOLTON, PA-C
2495 SHREVEPORT HWY
PINEVILLE, LA71360-4044
 Phone: 318-473-0010
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for GREG H BOLTON · (Male)

NPI # 1255448361
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/24/2006
Last updated 07/28/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • LA License # A10512
  • LA License # PA.A10512.RX
  • LA Other A10512 STATE LICENSE NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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