Individual
DR. ROY P. BOUCVALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 W ESPLANADE AVE, ANESTHESIA DEPT., KENNER, LA 70065-2467
(504) 464-8054
Mailing address
1025 SAINT LOUIS ST, NEW ORLEANS, LA 70112-3419
(504) 523-1054
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
011519
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1196061
—
LA
Enumeration date
05/28/2006
Last updated
10/20/2008
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