Individual
DR. ANTHONY COLLINS THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4630 AMBASSADOR CAFFERY PKWY, STE 208, LAFAYETTE, LA 70508-6949
(337) 981-6100
(337) 988-8751
Mailing address
4809 AMBASSADOR CAFFERY PKWY, SUITE 200, LAFAYETTE, LA 70508-6917
(337) 981-6100
(337) 988-8751
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
107454R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1493180
—
LA
01
—
990004179
PALMETTO GBA - RAILROAD M
LA
Enumeration date
07/07/2005
Last updated
08/14/2012
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