MEDICARE: DR. FRANCIS H BOUDREAU 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
1	208000000X	Pediatrics Physician	ME82841	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1134128929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS H BOUDREAU MD

Provider Business Mailing Address
First Line	:	1459 5TH AVE
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-2237
Country	:	US
Telephone Number	:	386-697-5383
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 BRULE ST
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-6100
Country	:	US
Telephone Number	:	502-626-9834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	12/18/2024

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