Individual
GILBERT A BOISSONNEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1140 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 868-1100
Mailing address
3333 PEPPERHILL RD, LEXINGTON, KY 40502-3808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA642
KY
Other
Enumeration date
07/08/2006
Last updated
07/08/2007
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