Organization
RANDY P BOULIGNY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY BOULIGNY M.D. (OWNER)
(504) 210-9826
Entity
Organization
Contact information
Practice address
1100 POYDRAS ST, SUITE 2900, NEW ORLEANS, LA 70163-1101
(504) 799-2219
Mailing address
PO BOX 791547, NEW ORLEANS, LA 70179-1547
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
021802
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1627593
—
LA
Enumeration date
07/25/2012
Last updated
07/25/2012
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