Individual
THOMAS CLAY CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1057 PAUL MAILLARD RD, LULING, LA 70070-4349
(985) 785-6242
(985) 785-5688
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
300573
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00978571
—
MS
05
—
2300105
—
LA
Enumeration date
03/27/2012
Last updated
05/03/2017
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