Jeremy M Boucher, MD; PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

23387 Issued in OK

Legal business name

JEREMY M BOUCHER, MD; PLLC

Practice address

4131 NW 122ND St
Oklahoma City, OK 73120-8869

Phone

(405) 775-9350

Fax

(405) 775-9360

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy M Boucher, MD

Title

Anesthesiologist

Phone

(405) 415-5405

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1730348491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 NW 122ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208869",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 NW 122ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208869",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY M BOUCHER, MD; PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "405-415-5405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "23387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.