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General NPI Number Information
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NPI Number | 1881033942
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Entity Type | Individual
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Provider Name | THOMAS TRIMBLE BOLTON PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 399 9TH ST N STE 300
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City | NAPLES
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State | FL
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Zip | 34102-5820
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Country | US
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Telephone | 239-624-4299
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Fax | 239-624-8856
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Provider Business Mailing Address
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Address Line | 118 SHENANDOAH DR STE A
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City | SHENANDOAH
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State | TX
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Zip | 77381-1203
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Country | US
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Telephone | 281-583-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.200628
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9119690
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA10741
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License Number State | TX
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