Provider Demographics
NPI:1790280477
Name:BOURGEOIS, VICTORIA CHRISTINE BONE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:CHRISTINE BONE
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:CHRISTINE
Other - Last Name:BONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8595 PICARDY AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3675
Mailing Address - Country:US
Mailing Address - Phone:225-237-1880
Mailing Address - Fax:
Practice Address - Street 1:8595 PICARDY AVE STE 320
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3675
Practice Address - Country:US
Practice Address - Phone:225-237-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330580207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program