THIBODAUX LASER AND SURGERY CENTER, LLC
Surgery Yellow Pages
Thibodaux, Louisiana
Provider NPI: 1073505616
Organization Information:Organization Name: THIBODAUX LASER AND SURGERY CENTER, LLC
Practice Location:
1101 AUDUBON AVE SUITE S4 THIBODAUX, LA 70301 US
Tel: 985-447-7246 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1101 AUDUBON AVE SUITE S4 THIBODAUX, LA 70301 US
Tel: 985-447-7246 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | LA | 107 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
1113514 | LA | 05 | |
RR MEDICARE | 490005391 | 01 | |
RR MEDICARE | P00168211 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin