Individual
JEFFREY J THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200-A ENERGY PARKWAY, SUITE 209, LAFAYETTE, LA 70508
(337) 233-9546
(337) 237-5723
Mailing address
120 RUE LOUIS XIV, LAFAYETTE, LA 70508-5739
(337) 769-7779
(337) 769-7800
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
021138
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1936120
—
LA
Enumeration date
09/25/2006
Last updated
04/25/2014
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