Lafourche Arc

Specialty details in registry · Thibodaux, LA

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At a glance

100 W Main St, Thibodaux, LA 70301-5216

NPPES record updated Aug 22, 2020. Public records can lag behind changes at a practice.

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Practice location

100 W Main St
Thibodaux, LA 70301-5216
Professional details: NPI, taxonomy & registry record
NPI1275685778
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320900000X
Enumeration date
Jan 17, 2007
Record updated
Aug 22, 2020
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320900000X · Primary

License reported: 6793 LA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

100 W Main St
Thibodaux, LA 70301-5216
Phone
(985) 447-6214
Fax
(985) 447-4813
Mailing address
100 W MAIN ST

THIBODAUX, LA 703015216
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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