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Dr. Jonathan Peter Boltax, MD
Pulmonary Disease Physician in Jackson, Wyoming
NPI 1629023692

Jonathan Peter Boltax is a Pulmonary Disease Physician based in Jackson, WY and is specialized in Pulmonary Disease. Jonathan Peter Boltax practices in Jackson, WY and has the professional credentials of MD. The NPI Number for Jonathan Peter Boltax is 1629023692 and holds a License No. 9935A (Wyoming).

The current practice location address for Jonathan Peter Boltax is 555 E Broadway Ave Ste 220, Jackson, WY and can be reached out via phone at 307-739-7305 and via fax at 307-739-4960.

Location: 555 E Broadway Ave Ste 220, Jackson, WY, 83001-0428
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629023692
Provider Name
Jonathan Peter Boltax
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
555 E Broadway Ave Ste 220, Jackson, WY, 83001-0428
Phone Number
307-739-7305
Fax Number
307-739-4960
Provider Enumeration Date
05/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
121002500 05 WY
institution
Provider Business Practice Location Address Details
Address
555 E Broadway Ave Ste 220
City
Jackson
State
Wyoming
Zip
83001-8640
Phone Number
307-739-7305
Fax Number
307-739-4960
person
Provider Business Mailing Address Details
Address
555 E Broadway Ave Ste 220
City
Jackson
State
Wyoming
Zip
83001-8640
Phone Number
307-739-7305
Fax Number
307-739-4960
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Pulmonary Disease
Taxonomy
207RP1001X
License No.
9935A (Wyoming)
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
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