# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Family Medicine Clinic - Thibodaux
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396570511
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 400 N ACADIA RD, THIBODAUX, LA 70301-4856
- **Practice address phone:** (985) 493-3034
- **Practice address fax:** (985) 493-3035
- **Mailing address:** 602 N ACADIA RD, THIBODAUX, LA 70301-4823
- **Mailing address phone:** (985) 494-4907
- **Mailing address fax:** (985) 449-2585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/06/2024
- **Last updated:** 06/01/2026