Organization
JAMES C. BOUDREAU, DPM, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES C. BOUDREAU DPM (PRESIDENT)
(414) 425-5140
Entity
Organization
Contact information
Practice address
6191 S. 108TH ST., HALES CORNERS, WI 53130
(414) 425-5140
(414) 425-7960
Mailing address
6191 S. 108TH ST., HALES CORNERS, WI 53130
(414) 425-5140
(414) 425-7960
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
349025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43260100
—
WI
Enumeration date
07/31/2006
Last updated
02/15/2012
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