Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Family Medicine Clinic - Pierre Part
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
3928 HIGHWAY 70 S, PIERRE PART, LA 70339-4460
(985) 369-6070
(985) 252-1400
Mailing address
602 NORTH ACADIA ROAD, CONTRACT MANAGEMENT DEPT., THIBODAUX, LA 70301
(985) 493-4907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/05/2023
Last updated
06/03/2025
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