Individual
DR. KENNETH JAMES CRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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 STE 200, THIBODAUX, LA 70301-4897
(985) 448-3700
(985) 448-3900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD10219R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1986011
—
LA
Enumeration date
06/01/2005
Last updated
02/24/2016
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