Teresa Boutwell, CST is a
Physician Assistant - Medical based in Oxford, Georgia. Teresa Boutwell is licensed to practice in Georgia (license number 91956) and her current practice location is
70 Ashford Dr, Oxford, Georgia. She can be reached at her office (for appointments etc.) via phone at
(770) 985-4257.
NPI number for Teresa Boutwell is 1669543203 and her current mailing address is Po Box 1938, Conyers, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669543203.
Provider's Profile
| Full Name | Teresa Boutwell |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant - Medical |
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| Location | 70 Ashford Dr, Oxford, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1669543203
- Provider Enumeration Date: 11/13/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Teresa Boutwell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669543203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 91956 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teresa Boutwell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Teresa Boutwell, CST
Po Box 1938,
Conyers, GA 30012-7291
Ph: (770) 985-4257 | Teresa Boutwell, CST
70 Ashford Dr,
Oxford, GA 30054-4648
Ph: (770) 985-4257 |
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