| Dr Jonathan Peter Boltax, MD | |
|
555 E Broadway Ave Ste 220, Jackson, WY 83001-8640 | |
| (307) 739-7305 | |
| (307) 739-4960 |
| Full Name | Dr Jonathan Peter Boltax |
|---|---|
| Gender | Male |
| Speciality | Pulmonary Disease |
| Experience | 23 Years |
| Location | 555 E Broadway Ave Ste 220, Jackson, Wyoming |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629023692 | NPI | - | NPPES |
| 121002500 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RP1001X | Internal Medicine - Pulmonary Disease | 9935A (Wyoming) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Johns Medical Center | Jackson, WY | Hospital |
| Star Valley Medical Center | Afton, WY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Teton County Hospital District | 4880582295 | 110 |
| Entity Name | Teton County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487818605 PECOS PAC ID: 4880582295 Enrollment ID: O20040308000954 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jonathan Peter Boltax, MD Po Box 428, Jackson, WY 83001-0428 Ph: (307) 739-7305 | Dr Jonathan Peter Boltax, MD 555 E Broadway Ave Ste 220, Jackson, WY 83001-8640 Ph: (307) 739-7305 |
Mrs. Blythe Elizabeth Cox, PA C Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 555 E Broadway, Suite 229, Jackson, WY 83001 Phone: 307-732-1039 Fax: 307-732-1041 | |
Michael Abram Tenofsky, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 625 E Broadway Ave, Jackson, WY 83001 Phone: 307-733-3636 Fax: 888-329-5701 | |
Dr. Cynthia L Archer, MD Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 1335 Arena Rd Unit 1, Jackson, WY 83001 Phone: 602-697-7790 Fax: 602-697-7790 | |
Dr. Martha Gene Stearn, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 555 E Broadway Ave Ste 207, Jackson, WY 83001 Phone: 307-733-8002 | |
Mark Matthew Neimat, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 625 E Broadway Ave, Jackson, WY 83001 Phone: 307-733-3636 Fax: 888-329-5701 | |
Anna Bramley Catino, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 555 E Broadway Ave Ste 229, Jackson, WY 83001 Phone: 307-739-7690 Fax: 307-739-4960 | |
Glenn Edward Burnett Ii, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 555 E Broadway Ave Ste 201, Jackson, WY 83001 Phone: 307-733-7222 Fax: 307-733-9720 |