Tommy Lester Fudge, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

03512R Issued in LA

Practice address

604 N Acadia Rd
Suite 409
Thibodaux, LA 70301

Phone

(985) 449-4670

Fax

(985) 449-2598

NPI assigned

Jul 5, 2005

Last updated

Jul 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thibodaux Regional Network Development Corporation

  • Anesthesiology Physician
  • Thibodaux, LA
  • NPI 1285658310
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1164429171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5478",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703025478",
            "telephone_number": "985-449-4670",
            "fax_number": "985-449-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD",
            "address_2": "SUITE 409",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-449-4670",
            "fax_number": "985-449-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDGE",
        "first_name": "TOMMY",
        "middle_name": "LESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "LA",
            "license": "03512R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1365475",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00790563",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Fortson, LPC
• Whitney France
• Lakesha M Franklin, MA
• Lane Mikael Frey, M.D.
• Megan Frost
• Nicholas S Fuglaar, FNP-C
• Ramona Galiano, RN
• Dionne Elizabeth Galliano, PLPC
• Paul J Ganier, LPC,PHD
• Ashley Gary, MS, RD, LDN

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.