| Thibodaux Regional Network Development Corporation | |
| 
					114 Hwy 403 Paincourtville LA 70391-0300  | |
| (985) 369-6070 | |
| (985) 369-3514 | 
| Full Name | Thibodaux Regional Network Development Corporation | 
|---|---|
| Speciality | Family Medicine | 
| Location | 114 Hwy 403, Paincourtville, Louisiana | 
| Authorized Official Name and Position | Kim Legendre Boudreaux (DIRECTOR OF CONTRACTINGS) | 
| Authorized Official Contact | 9854934907 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Thibodaux Regional Network Development Corporation Po Box 5478 Thibodaux LA 70302-5478 Ph: (985) 369-6070  | Thibodaux Regional Network Development Corporation 114 Hwy 403 Paincourtville LA 70391-0300 Ph: (985) 369-6070  | 
| NPI Number | 1396162269 | 
|---|---|
| Provider Enumeration Date | 03/27/2014 | 
| Last Update Date | 06/03/2025 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1396162269 | NPI | - | NPPES | 
| CN8396 | Other | LA | RAILROAD MEDICARE | 
| 2368311 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |