DR. KELLY JAMES BOUDREAUX JR. (NPI# 1205983194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205983194 |
| Entity Type | Individual |
| Full Name | DR. KELLY JAMES BOUDREAUX JR. |
| Credential | M.D. |
| Practice Address |
8080 Bluebonnet Blvd. Suite 3000 Baton Rouge LA 70810 |
| Mailing Address |
8080 Bluebonnet Blvd Suite 3000 Baton Rouge LA 70810 |
| Practice Telephone | 2257668100 |
| Practice Fax Number | 2254086896 |
| Mailing Telephone | 2257668100 |
| Mailing Fax Number | 2254086896 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 203731 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
8080 BLUEBONNET BLVD. SUITE 3000 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588631311 | Surgical Specialty Center of Baton Rouge, LLC | General Acute Care Hospital | 8080 Bluebonnet Blvd., Baton Rouge, LA 70810 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376723304 | Redfield E Bryan Jr. | Urology | 2020 Rue Provence, Baton Rouge, LA 70806-8361 | 2007-11-07 |
| 1457386310 | Charlie Haywood Bridges | Urology | 7777 Hennessy Blvd., Ste. 608, Baton Rouge, LA 70808 | 2006-07-11 |
| 1700813722 | Richard Gipson Carter | Urology | 6323 Jefferson Hwy, Baton Rouge, LA 70806-8020 | 2006-06-26 |
| 1417308354 | Bridges Urology | Urology | 7777 Hennessy Blvd Ste 608, Baton Rouge, LA 70808-4366 | 2016-06-22 |
| 1982996617 | Ross Cockrell | Urology | 7373 Perkins Rd, Baton Rouge, LA 70808 | 2011-05-13 |
| 1003129651 | Jason Peary Bridges | Urology | 7777 Hennessy Blvd Ste 608, Baton Rouge, LA 70808-4366 | 2010-07-23 |
| 1497072508 | Spyrie D Mays Md Apmc | Urology | 3401 North Blvd, Ste 340, Baton Rouge, LA 70806-3743 | 2010-04-28 |
| 1508180530 | Wesley Ray Porta | Urology | 7373 Perkins Rd, Baton Rouge, LA 70808-4326 | 2010-03-19 |
| 1487844668 | James Dudley Atkinson Iv | Urology | 9001 Summa Ave, Baton Rouge, LA 70809-3726 | 2007-07-25 |
| 1265633051 | Paul W Walker | Urology | 8080 Bluebonnet Blvd, Suite 3000, Baton Rouge, LA 70810-7827 | 2007-05-30 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70810 |
Please comment or provide details below to improve the information on DR. KELLY JAMES BOUDREAUX JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.