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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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