Organization
MATTHEW B. BOUDREAUX, M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW B BOUDREAUX M.D. (PRESIDENT)
(337) 233-0219
Entity
Organization
Contact information
Practice address
1103 W UNIVERSITY AVE, LAFAYETTE, LA 70506-3462
(337) 233-0219
(337) 233-2418
Mailing address
1103 W UNIVERSITY AVE, LAFAYETTE, LA 70506-3462
(337) 233-0219
(337) 233-2418
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1214868
—
LA
01
—
P00973633
RAILROAD MEDICARE
—
Enumeration date
07/15/2011
Last updated
11/17/2011
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