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Organization

ANTHONY W BOUTT MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTHONY W BOUTT M.D. (PHYSICIAN/OWNER)
(810) 987-3556
Entity
Organization

Contact information

Practice address
1522 PINE GROVE AVE STE C, PORT HURON, MI 48060-3382
(810) 987-3556
(810) 987-5090
Mailing address
1522 PINE GROVE AVE STE C, PORT HURON, MI 48060-3382
(810) 987-3556
(810) 987-5090

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301070173
MI

Other

Enumeration date
03/05/2014
Last updated
03/05/2014
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