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Individual

BEAU DAVID BOUDREAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
726 N ACADIA RD STE 3400, THIBODAUX, LA 70301-5009
(985) 449-4656
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 449-4656
(985) 449-2532

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.207047
LA
207RR0500X
Rheumatology Physician
Primary
MD.207047
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2153200
LA
Enumeration date
05/10/2011
Last updated
07/21/2022
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