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NPI Code Detail

MEDICARE: DR. ROY P. BOUCVALT MD

MEDICARE:  DR. ROY P. BOUCVALT  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician011519LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740237338
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROY P. BOUCVALT MD
Provider Business Mailing Address
First Line : 1025 SAINT LOUIS ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70112-3419
Country : US
Telephone Number : 504-523-1054
Fax Number :
Provider Business Practice Location Address
First Line : 180 W ESPLANADE AVE
Second Line : ANESTHESIA DEPT.
City : KENNER
State : LA
Zip : 70065-2467
Country : US
Telephone Number : 504-464-8054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 10/20/2008

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Directions to “ DR. ROY P. BOUCVALT MD” Practice Location

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