Maurice Louis Bouchard, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME56671 Issued in FL

Practice address

4724 N Davis Hwy
Pensacola, FL 32503-2339

Phone

(850) 696-4000

Fax

(850) 444-7057

NPI assigned

Dec 29, 2005

Last updated

Jun 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pensacola Urology, PA

  • Specialist
  • Pensacola, FL
  • NPI 1962489278
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1154308104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-696-4000",
            "fax_number": "850-444-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-696-4000",
            "fax_number": "850-444-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "MAURICE",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0056671",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME56671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063492100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher J. Bosarge, M.D.
• Kathy Keough Bosso, D.M.D.
• Amy Michelle Boswell, PHARMD
• Brandi Botsch, PA-C
• Kevin M. Botts, M.D.
• Shannon Christopher Boudreaux, MD
• Willena Boudreaux, PTA
• James Boulton
• Karen Bounds, ARNP
• Rachel Kathleen Bourguignon, MD

• Urology Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.