Individual
GARY EUGENE BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
985 9TH AVE SW, SUITE 403, BESSEMER, AL 35022-4500
(205) 481-8470
(205) 481-8473
Mailing address
2700 10TH AVE S, SUITE 305, BIRMINGHAM, AL 35205-1200
(205) 939-0139
(205) 939-4997
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1-092654
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-092654
AL
Other
Enumeration date
07/27/2005
Last updated
02/22/2010
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