Provider Demographics
NPI:1689037509
Name:BOLTON, NADEZHDA (DO)
Entity Type:Individual
Prefix:DR
First Name:NADEZHDA
Middle Name:
Last Name:BOLTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NADEZHDA
Other - Middle Name:
Other - Last Name:LAPIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 31598
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1598
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7900 S J STOCK RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-7012
Practice Address - Country:US
Practice Address - Phone:520-383-7237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008557207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology