Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TERESA BOUTWELL, CST
Active Sole ProprietorTERESA BOUTWELL, CST is a Medical Physician Assistant healthcare provider located in OXFORD, Georgia. NPI 1669543203 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · OXFORD, GA
Registration Details
- NPI Number
- 1669543203
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 13, 2006 (19.714796879078 yrs)
- Last Updated
- Jul 8, 2007
- License
-
91956 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
70 ASHFORD DROXFORD, GA, 300544648Browse GA providers · Browse ZIP 30054
- Phone
- 7709854257
- Fax
- 7709854258
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.