Mark Ricard Boudreau Jr., DO
Pediatrics Physician · Rome, GA
Practice location
304 Shorter Ave NW Ste 105Rome, GA 30165-4256
- Phone
- (706) 236-4880
NPI record
- NPI
- 1659834323
- Entity type
- Individual (Type 1)
- Enumeration date
- April 10, 2019
- Last updated
- May 26, 2023
- Certified
- May 26, 2023
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Physician Primary | 208000000X |
11273 | GA |
Mailing address
420 E 2ND Ave Ste 103Rome, GA 30161-3210
- Phone
- (706) 509-3000
Other practice locations (1)
- 2370 Rockmart Hwy Ste 100, Cedartown, GA 30125-6029 · (770) 748-7818
About Dr. Boudreau
Mark Ricard Boudreau Jr., DO is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 304 Shorter Ave NW Ste 105, Rome, GA 30165-4256. The NPI number 1659834323 was assigned on April 10, 2019 and the record was last updated on May 26, 2023.
Dr. Boudreau lists a license in the registry: #11273 (GA) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Mark Ricard Boudreau Jr., DO?
The NPI number is 1659834323.
What is the phone number of Dr. Boudreau?
The phone number listed for the practice location is (706) 236-4880.
Where is Dr. Boudreau located?
304 Shorter Ave NW Ste 105, Rome, GA 30165-4256.
What is the taxonomy code for Dr. Boudreau?
The primary taxonomy code is 208000000X – Pediatrics 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.
Other Pediatrics Physician providers in Rome
- Todd Rufus Kelley, MD85 John Maddox Drive Connector NW
- Bethany Wall Jackson, M.D.2112 Shorter Ave NW Ste 240
- Laura M. Dovan, M.D.330 Turner McCall Blvd.
- Erica Paez-Zapata, M.D.18 Riverbend Dr SW Ste 210
- David Michael Dohrmann, MD330 Turner McCall Blvd SW
- Redmond Physician Practice Co IV100 John Maddox Dr NW
- Caroline Du Yaphockun, MD85 John Maddox Drive Connector NW
- Elizabeth Anne Smith, M.D402 N 4TH Ave SW
- Imagine Pediatrics PC18 Riverbend Dr SW Ste 210
- Wajiha Farooq, PA-C140 Three Rivers Dr NE
- James Ruel McMillian, M.D.420 E 2ND Ave
- Melissa Dawn Davis, MD85 John Maddox Drive Connector NW