Individual
JOSEPH B. BOUCREE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1570 LINDBERG DR STE 8, SLIDELL, LA 70458-8084
(985) 205-3456
(985) 288-0047
Mailing address
1570 LINDBERG DR STE 8, SLIDELL, LA 70458-8084
(985) 205-3456
(985) 288-0047
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020305
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1182257
—
LA
Enumeration date
07/05/2006
Last updated
10/12/2015
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