OrganizationActive
Thibodaux Regional Network Development Corporation
NPI 1861249583 · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Thibodaux, LA
Provider details
- NPI number
- 1861249583
- Entity type
- Organization
- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kim Boudreaux, Director of Contracting(985) 493-4907
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Podiatric Clinic/Center261QP1100X
Ambulatory Health Care Facilities
- Wound Care Registered Nurse163WW0000X
Nursing Service Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Foot & Ankle Surgery Podiatrist213ES0103X
Podiatric Medicine & Surgery Service Providers
Practice location
290 Bowie Rd
Ste a
Thibodaux, LA 70301-6712
Phone: (985) 493-4990
Approximate (ZIP-level) locationGet directions
Mailing address
602 N Acadia Rd
Thibodaux, LA 70301
Other names (DBA / former)
- Doing business as
- Thibodaux Regional Wound Care & Limb Preservation Center
- Doing business as
- Thibodaux Regional Wound Care & Limb Preservation Center
Registry dates
- Enumerated
- 2024-05-01
- Last updated
- 2025-06-02
- Certified
- 2025-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.