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Contact Information

KELLY E BOUSSERT, MD
8080 BLUEBONNET BLVD STE 1000
BATON ROUGE, LA70810-7827
 Phone: 225-924-2424
 Fax: 225-408-7980
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for KELLY E BOUSSERT · (Female)

NPI Number 1679717136
Status Active
Credentials MD
Entity Individual
Enumeration date 04/28/2009
Last updated 06/15/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • LA License # MD.207144
  • LA Medicaid 1883450
Hospital affiliation(s)
  • BATON ROUGE GENERAL MEDICAL CENTER - (Acute Care)
    3600 FLORIDA STREET
    BATON ROUGE, LA 70806
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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