Individual
DR. THAD MICHAEL PRIMEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7097
(337) 436-9557
(337) 312-1311
Mailing address
830 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7097
(337) 436-9557
(337) 312-1311
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.202834
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1079154
—
LA
Enumeration date
05/23/2007
Last updated
08/26/2021
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