Individual
DR. PETER JAMES BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 NORTH BLVD, STE 330, BATON ROUGE, LA 70806
(225) 767-5520
Mailing address
PO BOX 14782, BATON ROUGE, LA 70898-4782
(225) 767-5520
(225) 767-4934
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
12995R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1563471
—
LA
01
—
2193181
AETNA
LA
Enumeration date
06/30/2005
Last updated
06/02/2020
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