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General NPI Number Information
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NPI Number | 1528179462
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Entity Type | Organization
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Legal Business Name | THIBODAUX WOMEN'S CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 506 N ACADIA RD
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City | THIBODAUX
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State | LA
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Zip | 70301-4862
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Country | US
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Telephone | 985-448-1216
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Fax | 985-446-8765
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Provider Business Mailing Address
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Address Line | 506 N ACADIA RD
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City | THIBODAUX
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State | LA
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Zip | 70301-4862
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Country | US
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Telephone | 985-448-1216
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Fax | 985-446-8765
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN H MILEK
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Credential | M.D.
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Telephone | 985-448-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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