Boudreaux, Jason Grady

Boudreaux, Jason Grady is an individual health care provider with primary practice located at 7777 Hennessy Blvd Ste 701 , Baton Rouge LA 70808-4370. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Boudreaux, Jason Grady can be contacted via phone (225) 765-8648.

Contact Information

Primary practice address
7777 Hennessy Blvd Ste 701 Baton Rouge LA 70808-4370
Phone: (225) 765-8648
Fax: (225) 765-7898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 301495 Louisiana

Profile Details

NPI number 1760757074
LBN Legal business name Boudreaux, Jason Grady
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2012
Last updated Jul 1st, 2024 - about 2 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 1760757074 NPPES
Louisiana MEDICAID 6199064
Louisiana Other 301495

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