Individual
MR. THADDEUS JASON BOUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP-BC
Contact information
Practice address
1110 E 6TH STREET SUITE E, MUSCLE SHOALS, AL 35661
(256) 314-2431
(256) 314-2435
Mailing address
1110 E 6TH STREET SUITE E, MUSCLE SHOALS, AL 35661-3669
(256) 314-2431
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1139488
AL
Other
Enumeration date
04/04/2013
Last updated
05/09/2019
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