Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Gastroenterology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
604 N ACADIA RD, STE 410, THIBODAUX, LA 70301-4897
(985) 493-4120
(985) 493-4121
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
06/02/2025
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