RENEE L BOULICAULT

KINGSPORT, TN
NPI1639148422
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: TN  70768)
Additional Taxonomies207V00000X Obstetrics & Gynecology
(Licence: MO  103629)
207V00000X Obstetrics & Gynecology
(Licence: WI  4868-320)
Enumeration Date2006-03-15
Last Update Date2024-09-26
Business Address
DR. RENEE L BOULICAULT M.D.
105 W PARK DR
KINGSPORT, TN 37660-3805
Phone number: 423-224-3220
Mailing Address
DR. RENEE L BOULICAULT M.D.
1021 W OAKLAND AVE STE 310
JOHNSON CITY, TN 37604-2192
Phone number: 423-302-6565