| Nathan Bolton, | |
|
103 Bennett Rd, Oliver Springs, TN 37840-5008 | |
| (865) 435-1933 | |
| Not Available |
| Full Name | Nathan Bolton |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 103 Bennett Rd, Oliver Springs, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376170514 | NPI | - | NPPES |
| Q058332 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 64355 (Tennessee) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Covenant Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457302010 PECOS PAC ID: 2860305463 Enrollment ID: O20060719000030 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan Bolton, 103 Bennett Rd, Oliver Springs, TN 37840-5008 Ph: (865) 435-1933 | Nathan Bolton, 103 Bennett Rd, Oliver Springs, TN 37840-5008 Ph: (865) 435-1933 |
Dr. Tersa L Lively, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 705 Main St Ste 2, Oliver Springs, TN 37840 Phone: 865-280-1466 Fax: 865-280-1469 | |
Dr. William B Bingham, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 103 Bennett Rd, Oliver Springs, TN 37840 Phone: 865-435-1933 Fax: 865-435-9316 | |
Carrie King White, NP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1030 Winter Gap Rd, Oliver Springs, TN 37840 Phone: 865-435-3918 Fax: 865-435-3920 |