Individual
TRAVIS JEFFERY BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-4680
(207) 622-4085
Mailing address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-4680
(207) 622-4085
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DO3299
ME
208600000X
Surgery Physician
TL6435
CO
Other
Enumeration date
06/07/2017
Last updated
08/01/2022
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