Provider Demographics
NPI:1710911623
Name:BOULTON, HAROLD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:MICHAEL
Last Name:BOULTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE PA
Mailing Address - State:PA
Mailing Address - Zip Code:17822-3034
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:869 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2207
Practice Address - Country:US
Practice Address - Phone:559-605-0310
Practice Address - Fax:559-605-0312
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA111525207P00000X
PAMD428158207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine