Thibodeaux, Ambrose Carroll
Thibodeaux, Ambrose Carroll is an sole proprietor health care provider with primary practice located at 1015 Choctaw Dr , Opelousas LA 70570-6567. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Medical Technologist, which is considered as his primary health care specialty. Thibodeaux, Ambrose Carroll can be contacted via phone (337) 934-6453.Contact Information
Primary practice address
1015 Choctaw Dr
Opelousas LA 70570-6567
Phone: (337) 934-6453
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Medical Technologist | 246QM0706X | CLP.G02111-GEN | Louisiana |
Profile Details
| NPI number | 1538342431 |
|---|---|
| LBN Legal business name | Thibodeaux, Ambrose Carroll |
| Credentials | Medical Technologist (MT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 13th, 2007 |
| Last updated | Dec 13th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538342431 | NPPES |
| Montana | Other | 1499 | BRD CLIN LAB SCIEN PRACT |
| Montana | Other | 19554TCL-0 | BRD CLIN LAB SCIEN PRACT |
| Montana | Other | CLP.G02111-GEN | BRD CLIN LAB SCIEN PRACT |
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