Organization
THIBODAUX ORTHOPAEDIC AND SPORTS MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL J MAKI M.D. (PRESIDENT)
(985) 446-6284
Entity
Organization
Contact information
Practice address
525 SAINT MARY ST, THIBODAUX, LA 70301-2627
(985) 446-6284
Mailing address
525 SAINT MARY ST, THIBODAUX, LA 70301-2627
(985) 446-6284
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
013892
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446611
—
LA
Enumeration date
10/05/2006
Last updated
11/15/2007
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