Jonathan Wyatt Bold M.D.

NPI 1053390021 - Radiology - 2085R0202X

NPI Details
NPI 1053390021
Gender Male
Enumeration Date 01/10/2006
Last Updated 06/24/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
2995 AMERICAN RIVER LN
LAS VEGAS NV, 89135-1713, US
Phone (952) 595-1301
Fax (612) 294-4903
Business Location
11995 SINGLETREE LN
SUITE 500
EDEN PRAIRIE MN, 55344-5347, US
Phone (952) 595-1301
Fax (612) 294-4903
Toxanomy
Taxonomy Code 2085R0202X
License State Nevada
License Number 10584
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According to our database, Dr. Jonathan Wyatt Bold M.D. NPI is 1053390021, taxonomy code is 2085R0202X and license number is 10584, license state is located at Nevada. Jonathan Wyatt Bold M.D. physically located at 2995 American River Ln, Las Vegas NV, 89135-1713. NPI Number Jonathan Wyatt Bold M.D. has the Individual type.

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1053390021 NPI number is provided on an as is basis without warranty of any kind. 1053390021 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Wyatt Bold M.D. are for informational purposes only.