# OUR LADY OF LOURDES REGIONAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OUR LADY OF LOURDES REGIONAL
- **Other names:** John S Thibodeaux MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093076275
- **Legal business name:** OUR LADY OF LOURDES REGIONAL
- **Authorized official:** MRS. KIM HEBERT (CFO)
- **Authorized official phone:** (337) 470-2593

## Contact information

- **Practice address:** 402 E EDWARD ST, ERATH, LA 70533-4114
- **Practice address phone:** (337) 937-5803
- **Practice address fax:** (337) 937-5806
- **Mailing address:** 4801 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6917
- **Mailing address phone:** (337) 470-2593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 13009 | LA | Yes |

## Other

- **Enumeration date:** 06/04/2012
- **Last updated:** 10/16/2012