Provider Demographics
NPI:1467587790
Name:BOQUET, MARK JAMES (MD, MPH, MS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JAMES
Last Name:BOQUET
Suffix:
Gender:M
Credentials:MD, MPH, MS
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Mailing Address - Street 1:21255 HIGHWAY 1
Mailing Address - Street 2:B2303 HEALTH SERVICES
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-5125
Mailing Address - Country:US
Mailing Address - Phone:225-353-8589
Mailing Address - Fax:
Practice Address - Street 1:21255 HIGHWAY 1
Practice Address - Street 2:B2303 HEALTH SERVICES
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-5125
Practice Address - Country:US
Practice Address - Phone:225-353-8589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200560207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine