Healthcare Provider Details

I. General information

NPI: 1295267136
Provider Name (Legal Business Name): CAITLIN LOPES BORNE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAITLIN ELIZABETH LOPES MD

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N ACADIA RD
THIBODAUX LA
70301-4847
US

IV. Provider business mailing address

602 N ACADIA RD
THIBODAUX LA
70301-4847
US

V. Phone/Fax

Practice location:
  • Phone: 985-493-4700
  • Fax:
Mailing address:
  • Phone: 985-493-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number336530
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: