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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 - Thibodaux
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
400 N ACADIA RD, THIBODAUX, LA 70301-4856
(985) 493-3034
(985) 493-3035
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 494-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
09/06/2024
Last updated
06/01/2026
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