DR. WALTER CLARK BOUTWELL (NPI# 1316908809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316908809 |
| Entity Type | Individual |
| Full Name | DR. WALTER CLARK BOUTWELL |
| Credential | MD |
| Practice Address |
207 Hunter Trl Pike Road AL 36064-3415 |
| Practice Telephone | 3346577198 |
| Practice Fax Number | 3342724876 |
| Mailing Telephone | 3346577198 |
| Mailing Fax Number | 3342724876 |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2012-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
MD-014439-E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001312743 | 05 | |
| MI | 4630520 | 05 |
| Street Address |
207 HUNTER TRL |
| City | PIKE ROAD |
| State | AL |
| Zip Code | 36064-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770068 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 9515 Vaughn Road, Pike Road, AL 36064 | 2020-11-03 |
| 1053806331 | Pike Road Dental, LLC | Clinic/Center | 31 Bridge St, Pike Road, AL 36064 | 2018-06-28 |
| 1437605292 | Woods Pt LLC | Physical Therapist | 9907 Turtle River Road, Pike Road, AL 36064 | 2016-08-31 |
| 1174854509 | Joseph Maurice Scanlan | Ophthalmology | 175 Pike Road Trail, Pike Road, AL 36064 | 2010-01-25 |
| 1821284514 | Colleen Irving Hawthorne | Speech-Language Pathologist | 345 Dansby Ct., Pike Road, AL 36064 | 2007-09-17 |
| 1285842617 | Rachel Lee Stewart | Physical Therapist | 9708 Silver Bell Ct, Pike Road, AL 36064 | 2007-05-18 |
| 1851565907 | Jeanell Jones Norvell | Counselor | 1196 Meriwether Rd, Pike Road, AL 36064-1721 | 2008-04-19 |
| 1295777126 | Theodore M Morgan Sr. | Emergency Medicine | 155 Glynlakes Dr, Pike Road, AL 36064-1767 | 2006-06-12 |
| 1710420351 | Melinda Landrum | Counselor | 9427 Vaughn Rd, Suite 27, Pike Road, AL 36064-2210 | 2016-11-30 |
| 1881160281 | Memendra Page Harris | Counselor | 9427 Vaughn Rd Ste F, Pike Road, AL 36064-2255 | 2018-10-23 |
| Find all providers in zip 36064 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336361732 | Tuscaloosa Newborn Medicine PC | Pediatrics | 1820 Rice Mine Rd North, Suite 200, Tuscaloosa, AL 35406-3282 | 2007-05-03 |
| 1629013412 | Virginia Anne Karle | Pediatrics | 1700 6th Ave S # 176f, Birmingham, AL 35233 | 2006-06-17 |
| 1225085608 | Brian Sims | Pediatrics | 619 20th Ave S, Nhb 525, Birmingham, AL 35205-6417 | 2006-05-30 |
| 1639126006 | Rune Toms | Pediatrics | 619 South 20th Street, 525 Nhb, Birmingham, AL 35294-0001 | 2006-05-30 |
| 1902857899 | Carl Herndon Coghill IIi | Pediatrics | 525 Nhb, 619 South 19th Street, Birmingham, AL 35249-0001 | 2006-05-15 |
| 1609837640 | Cynthia M Bonner | Pediatrics | 2019 Normandie Dr, Montgomery, AL 36111-2711 | 2006-03-29 |
| 1821075110 | Martha J Strange | Pediatrics | 2010 Brookwood Medical Center Dr, Birmingham, AL 35209-6804 | 2005-12-28 |
| 1023091378 | Meyer Edwin Dworsky | Pediatrics | 2324 Pansy St Sw, Huntsville, AL 35801-3803 | 2005-11-21 |
| 1245898683 | Usa Health Physician Billing Services LLC | Pediatrics | 1700 Center St, Mobile, AL 36604-3301 | 2019-05-31 |
| 1609337005 | Paige Sanders Miller | Pediatrics | 101 Sivley Rd Sw, Huntsville, AL 35801-4470 | 2019-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.