Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Oncology Clinic, Thibodaux Regional Cancer Institute
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
608 N ACADIA RD, FL 3, THIBODAUX, LA 70301-4847
(985) 493-4346
(985) 449-2560
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 493-4511
(985) 449-2535
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104675
—
LA
Enumeration date
09/22/2009
Last updated
06/03/2025
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