Organization
THE CENTER FOR PEDIATRIC AND ADOLESCENT MEDICINE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN D TOUPS (MANAGER)
(985) 448-3700
Entity
Organization
Contact information
Practice address
604 N ACADIA RD, SUITE 200, THIBODAUX, LA 70301-4897
(985) 448-3700
(985) 448-3900
Mailing address
604 N ACADIA RD, SUITE 200, THIBODAUX, LA 70301-4897
(985) 448-3700
(985) 448-3900
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948446
—
LA
Enumeration date
06/02/2005
Last updated
07/21/2022
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