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JOE RANDOLPH BOLTON MD NPI 1518055441


NPI Information

NPI: 1518055441
Provider Name: JOE RANDOLPH BOLTON, MD
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Individual
Address:
1377 E HERNDON AVE
#104
FRESNO, CA
ZIP 93720
Phone: (559) 450-7455
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Joe Randolph Bolton, MD is a thoracic surgery cardiothoracic vascular surgery in Fresno, CA. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. Joe Randolph Bolton, MD NPI is 1518055441. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1377 E HERNDON AVE
#104
FRESNO, CA
ZIP 93720-022
Phone: (559) 450-7455
Fax: (559) 450-7473

The enumeration date for this NPI number is 10/10/2006 and was last updated on 1/16/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)J3436TEXASNo
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)G88027CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1611356MEDICARE ID-TYPE UNSPECIFIEDTEXASMEDICARE
2PENDINGMEDICAIDTEXAS
3G33601MEDICARE UPINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.