Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JONATHAN PETER BOLTAX, MD
ActiveDR. JONATHAN PETER BOLTAX, MD is a Pulmonary Disease healthcare provider located in JACKSON, Wyoming. NPI 1629023692 is currently active in the NPPES registry. Verify at CMS.
Pulmonary Disease · JACKSON, WY
Registration Details
- NPI Number
- 1629023692
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 24, 2006 (20.217313819653 yrs)
- Last Updated
- Jan 4, 2024
- License
-
9935A (WY)
Practice Information
- Address
-
555 E BROADWAY AVE STE 220JACKSON, WY, 830018640Browse WY providers · Browse ZIP 83001
- Phone
- 3077397305
- Fax
- 3077394960
- Primary Specialty
-
Pulmonary Disease
207RP1001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.