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General NPI Number Information
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NPI Number | 1922184191
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Entity Type | Individual
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Provider Name | JEAN MICHAEL BOUQUET DO
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Gender | Male
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 12919 STROH RANCH CT UNIT G
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City | PARKER
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State | CO
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Zip | 80134-7707
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Country | US
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Telephone | 303-841-9219
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Fax | 303-841-9240
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Provider Business Mailing Address
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Address Line | 12919 STROH RANCH CT UNIT G
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City | PARKER
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State | CO
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Zip | 80134-7707
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Country | US
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Telephone | 303-841-9219
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Fax | 303-841-9240
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CO35599
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License Number State | CO
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