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Contact Information

JAMES C. BOUDREAU, DPM, SC
6191 S. 108TH ST.
HALES CORNERS, WI53130
 Phone: 414-425-5140
 Fax: 414-425-7960
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JAMES C. BOUDREAU, DPM, SC

NPI Number 1528074309
LBN Legal business name JAMES C. BOUDREAU, DPM, SC
Authorized official JAMES BOUDREAU - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/31/2006
Last updated 02/15/2012 - About 14 years ago
Identifiers
WI License # 349025
WI Medicaid 43260100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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