NPI age
7 years
Enumerated 2019-04-10
● Active
Type 1 · Individual
Mark Ricard Boudreau JR., DO
Boudreau is 1 of 23 pediatrics providers in Rome and 1 of 2726 in Georgia.
Primary specialty
Pediatrics
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-05-26
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2726 active pediatrics providers in Georgia.
NPI age
7 years
↓ 11 yr below median (18 yr)
State licenses
1 state
10% of peers hold multiple states
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2019 → 2026
2019-04Enumerated in NPPES
2019
2026
Where they practice
Practice location
304 Shorter Ave Nw Ste 105
Rome, GA 301654256
Mailing address
420 E 2nd Ave Ste 103
Rome, GA 301613210
Additional practice locations
1 secondary location on file with NPPES.
Location 2
2370 Rockmart Hwy Ste 100
Cedartown, GA 301256029
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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