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Organization

THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

Active
Other names
Thibodaux Regional Urology Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGEMENT)
(985) 493-4907
Entity
Organization

Contact information

Practice address
506 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 493-4907
(985) 449-2585
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 438-4831
(985) 449-2585

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
06/03/2020
Last updated
07/09/2025
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