Hayes-Boucher, Angela

Hayes-Boucher, Angela is an individual health care provider with primary practice located at 3120 Johnson Ferry Rd , Marietta GA 30062-5657. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Hayes-Boucher, Angela can be contacted via phone (770) 835-4741.

Contact Information

Primary practice address
3120 Johnson Ferry Rd Marietta GA 30062-5657
Phone: (770) 835-4741
Fax: (678) 401-6672
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 050762 Georgia

Profile Details

NPI number 1124017611
LBN Legal business name Hayes-Boucher, Angela
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Oct 6th, 2019 - about 7 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 1124017611 NPPES
Georgia MEDICAID 257244396F

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