SearchLouisiana101YP2500X

John Boudreaux, MA

NPI 1417669763 · on the registry since 2022

Practice

Address
4105 Kirkman St
Lake Charles, LA 70607
Phone
(337) 475-3105
Fax
(337) 475-3105
Organisation at this address
State Of La/Dhh/Obh
Genoa Healthcare Llc
Department Of Health And Hospitals
Imperial Calcasieu Human Services Authority
Imperial Calcasieu Human Services Authority
Inferred from a shared address, not stated in the registry.
Clinicians at this address
53

Additional practice sites

  • 2651 E Napoleon St, Sulphur, LA
  • 1925 Enterprise Blvd, Lake Charles, LA

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Licence states on file
LA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-11-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana