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Search › Mississippi › 390200000X

Logan Boutwell, MD

NPI 1649029729 · on the registry since 2024

Practice

Address
4500 13th St
Gulfport, MS 39501
Phone
(228) 867-4000
Organisation at this address
Boles Llc
Etas, Pllc
Caredoc Llc
Care Doc Llc
Care Doc Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
261

Registry record

Primary taxonomy
390200000X
390200000X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-05-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi