Individual provider Active NPI

Bradford William Bolton, PHARM.D

  • Nuclear Pharmacist
  • Doraville, GA
National Provider Identifier
1962793307
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear PharmacistTaxonomy code 1835N0905X
License
RPH024205 Issued in GA
Practice address
4000 Dekalb Technology Pkwy Ste 250
Doraville, GA 30340-2763
Phone
(770) 454-9481
NPI assigned
Apr 20, 2011
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Pharmacist 1835N0905X RPH024205 GA Primary

Addresses

Primary practice location

4000 Dekalb Technology Pkwy Ste 250
Doraville, GA 30340-2763

Mailing address

4000 Dekalb Technology Pkwy Ste 250
Doraville, GA 30340-2763
Phone (770) 454-9481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH024205GAMDNuclear Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1962793307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 DEKALB TECHNOLOGY PKWY STE 250",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303402763",
            "telephone_number": "770-454-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 DEKALB TECHNOLOGY PKWY STE 250",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303402763",
            "telephone_number": "770-454-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "BRADFORD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "GA",
            "license": "RPH024205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doraville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.