Jesse Allan Boutwell in Bandera - Medical
Jesse Allan Boutwell - NPI 1912977117
Jesse Allan Boutwell is a Medical in Bandera, Texas. Jesse Allan Boutwell practices all healthcare services and medical treatments related to Medical. The NPI Number for Jesse Allan Boutwell is 1912977117. The last update date is 2016-10-17.
Jesse Allan Boutwell's current location address is 1050 State Highway 16 S, Bandera, Texas. You can contact this provider via phone number 8302610684. The mailing address for Jesse Allan Boutwell is 1050 State Highway 16 S, Bandera, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jesse Allan Boutwell |
|---|---|
| Address | 1050 State Highway 16 S, Bandera, Texas |
| Phone Number | 8302610684 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PHYSICIAN |
NPI Number Detail
| NPI Number | 1912977117 |
|---|---|
| Provider Enumeration Date | 2006-01-23 |
| Last Updated Date | 2016-10-17 |
Provider Mailing Address Detail
| Address | 1050 State Highway 16 S |
|---|---|
| City | Bandera |
| State | Texas (TX) |
| Post Code | 780034830 |
| Phone Number | 8302610684 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA00055 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| Z142263 | PTAN |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jesse Allan Boutwell by the Centers for Medicare & Medicaid Services?
The Jesse Allan Boutwell has been issued the NPI (National Provider Identifier) 1912977117 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Jesse Allan Boutwell is located?
The Jesse Allan Boutwell is situated at the following address: 1050 State Highway 16 S, Bandera, TX, 780034830.
What is Jesse Allan Boutwell's area of expertise and its corresponding taxonomy classification?
The Jesse Allan Boutwell's field of specialization is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Jesse Allan Boutwell receive its 1912977117 assignment from the Centers for Medicare & Medicaid Services?
The Jesse Allan Boutwell was assigned its 1912977117 by the Centers for Medicare & Medicaid Services on 2006-01-23.
When was the information related to Jesse Allan Boutwell most recently updated or refreshed?
The details pertaining to the Jesse Allan Boutwell, including its address, specialty, and other relevant information, were last updated or refreshed on 2016-10-17.