Individual
DR. KERRY THOMAS THIBODEAUX
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
1270 ATTAKAPAS DR, STE 202, OPELOUSAS, LA 70570-6549
(337) 948-4362
(337) 942-6523
Mailing address
1270 ATTAKAPAS DR, STE 202, OPELOUSAS, LA 70570-6549
(337) 948-4362
(337) 942-6523
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
019158
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1374105
—
LA
Enumeration date
03/20/2006
Last updated
07/08/2007
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