NPI 1699769869 · live from the CMS NPI Registry
Rene Albert Boucher, DO
Pain Medicine, Interventional Pain Medicine in Bowling Green, KY. National Provider Identifier 1699769869, active.
NPI record
| NPI | 1699769869 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pain Medicine, Interventional Pain Medicine 208VP0014X |
| Practice location | 165 Natchez Trace Ave, Suite 205, Bowling Green, KY 42103 |
| Practice phone | 270-282-2024 |
| Mailing address | 350 Park St, Ste 203 B, Bowling Green, KY 42101 |
| Enumerated | September 2, 2005 |
| Last updated | September 18, 2009 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology | 207L00000X | 02561 (KY) |
| Anesthesiology, Pain Medicine | 207LP2900X | 02561 (KY) |
| Pain Medicine, Interventional Pain Medicine primary | 208VP0014X | 02561 (KY) |
| 208VP0000X | 02561 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.