MEDICARE: GARY EUGENE BOUTWELL CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	1-092654	AL
2	367500000X	Certified Registered Nurse Anesthetist	1-092654	AL

General Provider Information

NPI Number	:	1255331708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY EUGENE BOUTWELL CRNA

Provider Business Mailing Address
First Line	:	2700 10TH AVE S
Second Line	:	SUITE 305
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1200
Country	:	US
Telephone Number	:	205-939-0139
Fax Number	:	205-939-4997

Provider Business Practice Location Address
First Line	:	985 9TH AVE SW
Second Line	:	SUITE 403
City	:	BESSEMER
State	:	AL
Zip	:	35022-4500
Country	:	US
Telephone Number	:	205-481-8470
Fax Number	:	205-481-8473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	02/22/2010

Similar Medicare Providers

1417944257 — THOMAS ANTHONY PACE MD
Practice Location Address:

985 9TH AVE SW , SUITE 309
BESSEMER, AL
35022-4500

Practice Phone: 205-481-7373
Practice Fax: 205-481-7375

1013997808 — JANE ANN GEHLSEN MD
Practice Location Address:

985 9TH AVE SW , SUITE 404
BESSEMER, AL
35022-4500

Practice Phone: 205-481-8475
Practice Fax: 205-481-8478

1376658195 — MR. KERRY A PRICKETT
Practice Location Address:

985 9TH AVE SW
BESSEMER, AL
35022-4500

Practice Phone: 205-426-3784
Practice Fax: 205-426-3763

1265543482 — DR. THOMAS CARL PENDLETON M.D.
Practice Location Address:

985 9TH AVE SW , SUITE 406
BESSEMER, AL
35022-4500

Practice Phone: 205-481-7470
Practice Fax: 205-481-7469

1538255922 — ALABAMA DIGESTIVE DISEASES,P.C
Practice Location Address:

985 9TH AVE SW , SUITE 307
BESSEMER, AL
35022-4500

Practice Phone: 205-481-7384
Practice Fax: 205-481-7389

1447325337 — MS. SUE ELLEN KASLAR BULLOCK MSW
Practice Location Address:

985 NINTH AVE SW , SUITE 201
BESSEMER, AL
35022-4500

Practice Phone: 205-425-6395
Practice Fax: 205-481-8558

Directions to “ GARY EUGENE BOUTWELL CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.