Larry T. Bolton, M.D.,P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5951 Issued in AL

Legal business name

LARRY T. BOLTON, M.D.,P.C.

Practice address

303 Parks Ave
Scottsboro, AL 35768-2411

Phone

(256) 574-3623

Fax

(256) 574-6223

NPI assigned

Sep 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Larry T Bolton, M.D.

Title

Owner

Phone

(256) 574-3623

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1104133495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PARKS AVE",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682411",
            "telephone_number": "256-574-3623",
            "fax_number": "256-574-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKS AVE",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682411",
            "telephone_number": "256-574-3623",
            "fax_number": "256-574-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY T. BOLTON, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-574-3623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "AL",
            "license": "5951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000569",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Scottsboro, AL
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.