Organization
THIBODEAUX MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK THIBODEAUX NP (NURSE PRACTITIONER)
(337) 324-8060
Entity
Organization
Contact information
Practice address
1303 HORRIDGE ST, VINTON, LA 70668-4531
(337) 324-8060
(337) 324-8061
Mailing address
1303 HORRIDGE ST, VINTON, LA 70668-4531
(337) 324-8060
(337) 324-8061
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/15/2019
Last updated
04/21/2026
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