Individual
JORDAN P THIBODAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
999 ROBERT BLVD, SLIDELL, LA 70458-2009
(985) 643-7894
(985) 649-2183
Mailing address
999 ROBERT BLVD, SLIDELL, LA 70458-2009
(985) 643-7894
(985) 649-2183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
022074
LA
Other
Enumeration date
07/28/2017
Last updated
01/17/2023
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