Healthcare Provider Details

I. General information

NPI: 1366563785
Provider Name (Legal Business Name): CHRISTINA LOUISE BOULTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N. ALVERNON WAY 2ND FLOOR
TUSCON AZ
85711
US

IV. Provider business mailing address

P.O. BOX 245064
TUSCON AZ
85724-5064
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8000
  • Fax: 520-694-8005
Mailing address:
  • Phone: 520-626-9245
  • Fax: 520-626-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL-224770
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD72644
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD72644
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number51815
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: