Organization
KIDNEY CENTER OF SOUTH LOUISIANA, AMC
Active
Parent organization
KIDNEY CENTER OF SOUTH LOUISIANA, AMC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDNEY CENTER OF SOUTH LOUISIANA, AMC
Authorized official
MRS. VICKI C. LEDET (PRACTICE ADMINISTRATOR)
(985) 446-0871
Entity
Organization
Contact information
Practice address
604 N. ACADIA RD., SUITE 405, THIBODAUX, LA 70301
(985) 446-0871
(985) 446-0874
Mailing address
604 N. ACADIA RD., SUITE 405, THIBODAUX, LA 70301
(985) 446-0871
(985) 446-0874
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH9035
RAILROAD MEDICARE
LA
Enumeration date
05/10/2007
Last updated
09/12/2018
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