Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Plastic & Reconstructive Surgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
(985) 493-4907
Entity
Organization
Contact information
Practice address
608 N ACADIA RD, STE 3B, THIBODAUX, LA 70301-4847
(985) 493-4490
(985) 493-4491
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 493-4907
(984) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
06/03/2020
Last updated
06/02/2025
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