Individual
ORLAND KENTON BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3830
AZ
363AS0400X
Surgical Physician Assistant
010398
NY
Other
Enumeration date
03/30/2007
Last updated
09/10/2020
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