Boucher, Andrew Bradley

Boucher, Andrew Bradley is an individual health care provider with primary practice located at 6325 Humphreys Blvd , Memphis TN 38120-2300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Boucher, Andrew Bradley can be contacted via phone (901) 522-7700.

Contact Information

Primary practice address
6325 Humphreys Blvd Memphis TN 38120-2300
Phone: (901) 522-7700
Fax: (901) 522-2600
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 29063 Mississippi
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 62615 Tennessee

Profile Details

NPI number 1548689482
LBN Legal business name Boucher, Andrew Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2014
Last updated Nov 12th, 2021 - about 5 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 1548689482 NPPES
Mississippi MEDICAID 07507017
Mississippi MEDICAID Q065607

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