Boullard, Nicholas

Boullard, Nicholas is an individual health care provider with primary practice located at 4026 N State St , Jackson MS 39206-5754. 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 / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Boullard, Nicholas can be contacted via phone (601) 813-3446.

Contact Information

Primary practice address
4026 N State St Jackson MS 39206-5754
Phone: (601) 813-3446
Fax:
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 / General Practice 208D00000X 28006 Mississippi

Profile Details

NPI number 1811492309
LBN Legal business name Boullard, Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2018
Last updated Aug 11th, 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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