Floyd T Boudreau, MD
Individual provider Active NPI Clinical Pathology/Laboratory Medicine Physician · Mobile, AL
NPI 1487635017 · NPPES record last updated Jul 22, 2010
Key facts
- NPI
- 1487635017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician 207ZP0105X
- License
- 4218 (AL)
- Practice address
- 5 Mobile Infirmary Cir
Mobile, AL 36607-3513 - Phone
- (251) 460-0326
- Fax
- (251) 460-2846
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4218 | AL | MD | Clinical Pathology/Laboratory Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Infirmary Association | Current | Accepting new patients | |
| Mobile Infirmary Association | Current | Accepting new patients |
Locations
5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 4218 | AL | Yes |
Addresses
Primary practice location
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Mailing address
PO Box 91498
Mobile, AL 36691-1498
Phone (251) 460-0326
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009939513 | Medicaid | AL | |
| 009912503 | Medicaid | AL |
Other providers in Mobile, AL
- Judith Boswell
- Jon Botts
- Helen Elizabeth Boucher
- Michael J Boucher
- Susan Marisa Boucher
- Carole Boudreaux
- Evangeline Simone Boudreaux
- Michael C Boudreaux
- Randall C Boudreaux
- Sheila Bouler
All providers in Mobile, AL · Clinical Pathology/Laboratory Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.