Bouchard, James L

Bouchard, James L is an individual health care provider with primary practice located at 15 Hurricane Shoals Rd Ne Suite A, Lawrenceville GA 30046-4454. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Bouchard, James L can be contacted via phone (770) 255-0434.

Contact Information

Primary practice address
15 Hurricane Shoals Rd Ne Suite A Lawrenceville GA 30046-4454
Phone: (770) 255-0434
Fax: (770) 255-0433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD000418 Georgia

Profile Details

NPI number 1275521270
LBN Legal business name Bouchard, James L
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Feb 5th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275521270 NPPES
Georgia MEDICAID 00118148F

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