Individual
JOHN R BLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
604 N ACADIA RD STE 500, THIBODAUX, LA 70301-4743
(985) 448-1216
(985) 446-8765
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 448-1216
(985) 446-8765
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
021082
LA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.021082
LA
207VG0400X
Gynecology Physician
Primary
021082
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700315
UNITED HEALTH CARE
LA
05
—
1991180
—
LA
01
—
5397025
AETNA PPO OF LOUISIANA
LA
Enumeration date
09/07/2006
Last updated
04/13/2026
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