Healthcare Provider Details

I. General information

NPI: 1386858256
Provider Name (Legal Business Name): RICHARD LLOYD HARGETT JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N ACADIA RD
THIBODAUX LA
70301-4847
US

IV. Provider business mailing address

PO BOX 1449
THIBODAUX LA
70302-1449
US

V. Phone/Fax

Practice location:
  • Phone: 985-493-4750
  • Fax:
Mailing address:
  • Phone: 985-446-8994
  • Fax: 985-447-8385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number105086
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP05227
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: