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Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Family Medicine Clinic - Paincourtville
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTINGS)
(985) 493-4907
Entity
Organization
Contact information
Practice address
114 HWY 403, PAINCOURTVILLE, LA 70391-0300
(985) 369-6070
(985) 369-3514
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 369-6070
(985) 369-3514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/27/2014
Last updated
06/03/2025
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