Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Rheumatology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
726 N ACADIA RD, STE 3400, THIBODAUX, LA 70301-5011
(985) 449-4656
(985) 449-2532
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 449-4656
(985) 449-2532
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2420852
—
LA
Enumeration date
09/13/2010
Last updated
06/02/2025
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