Provider Demographics
NPI:1366563785
Name:BOULTON, CHRISTINA LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:BOULTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 245064
Mailing Address - Street 2:
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5064
Mailing Address - Country:US
Mailing Address - Phone:520-626-9245
Mailing Address - Fax:520-626-2668
Practice Address - Street 1:707 N. ALVERNON WAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85711
Practice Address - Country:US
Practice Address - Phone:520-694-8000
Practice Address - Fax:520-694-8005
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-224770207X00000X
MDD72644207X00000X, 207XS0117X
AZ51815207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD72644OtherLISENCE