| Organization Name: | LOYD H BOULET JR MD A PROFESSIONAL MEDICAL CORPORATION |
| NPI Number: | 1164676664 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOYD HONORE BOULET (OWNER) |
| Mailing Address: | 1270 Attakapas Dr Opelousas |
| State: | LA US |
| Postal Code: | 705706549 |
| Phone Number: | 3379426324 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2008 |
| NPI Last Update Date: | 11/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 009095 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |