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Organization
BOULET MEDICAL CLINIC
Active
Organization
BOULET MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOYD HONORE BOULET JR. GP (OWNER)
(337) 942-6324
Entity
Organization
Contact information
Practice address
8676 HIGHWAY 182, OPELOUSAS, LA 70570-5602
(337) 942-6324
(337) 942-8573
Mailing address
8676 HIGHWAY 182, OPELOUSAS, LA 70570-5602
(337) 942-6324
(337) 942-8573
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1090085
—
LA
01
—
4366078090
BLUECROSSBLUESHIELD
LA
Enumeration date
10/04/2006
Last updated
08/07/2008
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