# BOULET MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205921442
- **Authorized official:** DR. LOYD HONORE BOULET JR. GP (OWNER)
- **Authorized official phone:** (337) 942-6324

## Contact information

- **Practice address:** 8676 HIGHWAY 182, OPELOUSAS, LA 70570-5602
- **Practice address phone:** (337) 942-6324
- **Practice address fax:** (337) 942-8573
- **Mailing address:** 8676 HIGHWAY 182, OPELOUSAS, LA 70570-5602
- **Mailing address phone:** (337) 942-6324
- **Mailing address fax:** (337) 942-8573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 08/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1090085 | — | LA |
| 01 | — | 4366078090 | BLUECROSSBLUESHIELD | LA |