| NPI | 1578360327 |
|---|---|
| Doing Business As | THIBODAUX REGIONAL SURGICAL SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | KIM LEGENDRE BOUDREAUX Director Of Contracting 985-493-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-06-02 |