| Chester G Boudreaux Md Inc | |
|
142 Rue Marguerite Thibodaux LA 70301-6708 | |
| (985) 446-2131 | |
| (985) 447-3383 |
| Full Name | Chester G Boudreaux Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 142 Rue Marguerite, Thibodaux, Louisiana |
| Authorized Official Name and Position | Chester G Boudreaux (PRESIDENT) |
| Authorized Official Contact | 9854462131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chester G Boudreaux Md Inc 142 Rue Marguerite Thibodaux LA 70301-6708 Ph: (985) 446-2131 | Chester G Boudreaux Md Inc 142 Rue Marguerite Thibodaux LA 70301-6708 Ph: (985) 446-2131 |
| NPI Number | 1851833396 |
|---|---|
| Provider Enumeration Date | 11/15/2016 |
| Last Update Date | 11/15/2016 |
| Medicare PECOS PAC ID | 2365725462 |
|---|---|
| Medicare Enrollment ID | O20170216000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851833396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chester G Boudreaux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073502472 PECOS PAC ID: 3476642802 Enrollment ID: I20071207000486 |
| Provider Name | Heather T Thomassie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548613136 PECOS PAC ID: 3476836412 Enrollment ID: I20170216002023 |
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