person
Mr. Ambrose Carroll Thibodeaux JR., MT
Medical Technologist in Opelousas, Louisiana
NPI 1538342431

Ambrose Carroll Thibodeaux JR. is a Medical Technologist based in Opelousas, LA and is specialized in Medical Technologist. Ambrose Carroll Thibodeaux JR. practices in Opelousas, LA and has the professional credentials of MT. The NPI Number for Ambrose Carroll Thibodeaux JR. is 1538342431 and holds a License No. CLP.G02111-GEN (Louisiana).

The current practice location address for Ambrose Carroll Thibodeaux JR. is 1015 Choctaw Dr, Opelousas, LA and can be reached out via phone at 337-934-6453.

Location: 1015 Choctaw Dr, Opelousas, LA, 70570-6567
person
Provider Profile Details
NPI Number
1538342431
Provider Name
Ambrose Carroll Thibodeaux JR.
Credential
MT
Provider Entity Type
Individual
Gender
Male
Address
1015 Choctaw Dr, Opelousas, LA, 70570-6567
Phone Number
337-934-6453
Fax Number
Provider Enumeration Date
12/13/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1499 01 MT BRD CLIN LAB SCIEN PRACT
19554TCL-0 01 NE BUR OF LIC & CERT.
CLP.G02111-GEN 01 LA ST BRD MEDICAL EXAMINES
institution
Provider Business Practice Location Address Details
Address
1015 Choctaw Dr
City
State
Zip
70570-6567
Phone Number
337-934-6453
Fax Number
person
Provider Business Mailing Address Details
Address
1015 Choctaw Dr
City
State
Zip
70570-6567
Phone Number
337-934-6453
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Pathology
Speciality
Medical Technologist
Taxonomy
License No.
CLP.G02111-GEN (Louisiana)
Definition
Definition to come...
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