Benjamin Boudreaux (NPI# 1720256365, PAC ID# 8628142502) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1720256365 |
| PAC ID by PECOS | 8628142502 |
| Professional Enrollment ID | I20080812000026 |
| Full Name | Benjamin Boudreaux |
| Organization Legal Name | NORTHSHORE PLASTIC SURGERY, LLC |
| Address |
4000 Lonesome Rd Mandeville LA 70448-7085 |
| Phone Number | 2255884644 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2001 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 8022162684 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190040 | SLIDELL MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4000 Lonesome Rd, Mandeville, LA 70448-7085 | 2255884644 | NORTHSHORE PLASTIC SURGERY, LLC |
| 4000 Lonesome Rd, A, Mandeville, LA 70448-7085 | 2255884644 | NORTHSHORE PLASTIC SURGERY, LLC |
| Organization Legal Name | NORTHSHORE PLASTIC SURGERY, LLC |
| Physicians | 1 |
| Street Address |
4000 LONESOME RD |
| City | MANDEVILLE |
| State | LA |
| Zip | 70448-7085 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julie M Shreve | Clinical Social Worker | 249 W Causeway Approach, Mandeville, LA 70448-3032 | |
| Jeffrey C Miller | Chiropractic | Integrated Wellness Group LLC | 3441 E Causeway Approach D, Integrated Spine and Disc, Mandeville, LA 70448-3480 |
| Katie W Carpenter | Chiropractic | Integrated Wellness Group LLC | 3441 E Causeway Approach D, Integrated Spine and Disc, Mandeville, LA 70448-3480 |
| Elise D Levens | Chiropractic | Integrated Wellness Group LLC | 3441 E Causeway Approach D, Integrated Spine and Disc, Mandeville, LA 70448-3480 |
| Jessica C St Pierre | Clinical Social Worker | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Erin M Conlin | Internal Medicine | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Michael Green Sawyer | Psychologist, Clinical | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Ronald J. Kluchin | Internal Medicine | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Deena Provance | Clinical Social Worker | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Amanda Wright | Psychiatry | Ochsner Clinic LLC | 2810 E Causeway Approach, Mandeville, LA 70448-3502 |
| Find all physicians in zip 70448 | |||
| City | MANDEVILLE |
| Zip Code | 70448 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | MANDEVILLE + PLASTIC AND RECONSTRUCTIVE SURGERY |
Please comment or provide details below to improve the information on Benjamin Boudreaux.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.