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Organization
THIBODAUX LASER AND SURGERY CENTER, LLC
Active
Organization
THIBODAUX LASER AND SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD L ARCENEAUX M.D. (MANAGER)
(985) 447-7246
Entity
Organization
Contact information
Practice address
105 SAINT BERNARD ST, THIBODAUX, LA 70301-6549
(985) 446-0506
(985) 448-1521
Mailing address
105 SAINT BERNARD ST, THIBODAUX, LA 70301-6549
(985) 446-0506
(985) 448-1521
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
107
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113514
—
LA
01
—
490005391
RR MEDICARE
—
01
—
P00168211
RR MEDICARE
—
Enumeration date
08/19/2005
Last updated
11/22/2022
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