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Contact Information

JACQUE A BOUTWELL JR, CFA
3301 COUNTY RD 6 E
ELKHART, IN46514-7673
 Phone: 574-214-7504
 Fax: 574-262-3214
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Assistant

246ZC0007X
Indicates primary specialty

NPI Profile & details for JACQUE A BOUTWELL JR · (Male)

NPI # 1013062405
Status Active
Credentials CFA
Entity Individual
Enumeration date 01/24/2007
Last updated 11/25/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • IN Other 000000577411 ANTHEM BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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