# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Orthopaedic linic, Thibodaux Regional Network Development Corporation-Orthopaedic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790115772
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 602 N ACADIA RD STE 101, THIBODAUX, LA 70301-4848
- **Practice address phone:** (985) 446-6285
- **Practice address fax:** (985) 447-1754
- **Mailing address:** PO BOX 5478, THIBODAUX, LA 70302-5478
- **Mailing address phone:** (985) 446-6284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/12/2013
- **Last updated:** 09/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2351966 | — | LA |