Individual
BERNARD ROGER BOULANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
740 SOUTH LIMESTONE, LEXINGTON, KY 40536-0001
(859) 257-3253
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 218-5677
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
34259
KY
2086S0127X
Trauma Surgery Physician
34259
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64342959
—
KY
Enumeration date
05/08/2006
Last updated
01/03/2013
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