John Anthony Boudreau, MD

Orthopaedic Surgery Physician · Saint Louis, MO

Individual Active NPI

NPI number 1053338640

Practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 257-8000
Fax
(314) 268-5121

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NPI record

NPI
1053338640
Entity type
Individual (Type 1)
Enumeration date
July 17, 2006
Last updated
May 3, 2021
Certified
May 3, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Orthopaedic Surgery Physician Primary 207X00000X D0063481 MD

Mailing address

3691 Rutger Ave
Provider Enrollment
St Louis, MO 63110
Phone
(314) 977-4440

About Dr. Boudreau

John Anthony Boudreau, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Orthopaedic Surgery Physician (code 207X00000X). The practice location is 1201 S Grand Blvd, Saint Louis, MO 63104-1016. The NPI number 1053338640 was assigned on July 17, 2006 and the record was last updated on May 3, 2021.

Dr. Boudreau lists a license in the registry: #D0063481 (MD) for Orthopaedic Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John Anthony Boudreau, MD?

The NPI number is 1053338640.

What is the phone number of Dr. Boudreau?

The phone number listed for the practice location is (314) 257-8000.

Where is Dr. Boudreau located?

1201 S Grand Blvd, Saint Louis, MO 63104-1016.

What is the taxonomy code for Dr. Boudreau?

The primary taxonomy code is 207X00000X – Orthopaedic Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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