Individual
MANDY LYNN BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
118 N HOSPITAL DR, ABBEVILLE, LA 70510-4039
(337) 893-6294
(337) 893-6369
Mailing address
P O BOX 1152, ABBEVILLE, LA 70511-1152
(337) 893-6294
(337) 893-6369
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
201161
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1706639
—
LA
01
—
UPIN # I64230
UPIN #
LA
Enumeration date
10/03/2006
Last updated
01/09/2013
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