Organization
KERRY T. THIBODEAUX MD APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY T. THIBODEAUX MD FACS (OWNER)
(337) 948-4362
Entity
Organization
Contact information
Practice address
1233 WAYNE GILMORE CIRLCE, SUITE 205B, OPELOUSAS, LA 70570
(337) 948-4362
(337) 942-6523
Mailing address
1233 WAYNE GILMORE CIRLCE, SUITE 205B, OPELOUSAS, LA 70570
(337) 948-4362
(337) 942-6523
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
019158
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1374105
—
LA
Enumeration date
06/26/2006
Last updated
08/22/2020
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