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DR. BLAINE PHILLIP BOUTTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
108 SUMTER AVE, BROUSSARD, LA 70518-7312
(337) 654-1823
Mailing address
108 SUMTER AVE, BROUSSARD, LA 70518-7312
(337) 654-1823

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
348187
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/22/2022
Last updated
02/03/2026
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