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Individual

DR. JAMES L BOUCHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
15 HURRICANE SHOALS RD NE, SUITE A, LAWRENCEVILLE, GA 30046-4454
(770) 255-0434
(770) 255-0433
Mailing address
PO BOX 491658, LAWRENCEVILLE, GA 30049-0028
(770) 255-0434
(770) 255-0433

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000418
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118148F
GA
Enumeration date
10/12/2005
Last updated
02/05/2014
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