Healthcare Provider Details

I. General information

NPI: 1699129676
Provider Name (Legal Business Name): TIMOTHY CHARLES BOSWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S STE 318
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S STE 318
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9840
  • Fax:
Mailing address:
  • Phone: 205-638-9840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number46099
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number46099
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: