Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Orthopaedic linic, Thibodaux Regional Network Development Corporation-Orthopaedic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
602 N ACADIA RD STE 101, THIBODAUX, LA 70301-4848
(985) 446-6285
(985) 447-1754
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 446-6284
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2351966
—
LA
Enumeration date
11/12/2013
Last updated
09/05/2023
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