Individual
JOHN G BOULET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SIVLEY RD SW, EM DEPT, HUNTSVILLE, AL 35801-4421
(256) 265-9905
(256) 265-9910
Mailing address
PO BOX 11407, DRAWER 0314, BIRMINGHAM, AL 35246-0314
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.27888
AL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
G3171
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009943232
—
AL
01
—
051004447
BCBS
AL
05
—
051558705
—
AL
01
—
4134776
AETNA
AL
Enumeration date
04/14/2006
Last updated
02/09/2010
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