Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnathan Lloyd Wise, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1992125355

Johnathan Lloyd Wise, MD is an Obstetrics/Gynecology in Thibodaux, Louisiana. Graduated from Louisiana State University School of Medicine in Shreveport in 2013, 13 years ago. Practices with Thibodaux Regional Network Development Corporation, a 135-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
13
Trained at
Louisiana State University School of Medicine in Shreveport
Licensed in
LA
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

406 N Acadia Rd
Thibodaux, LA 70301-4856
Phone: (985) 446-2890
Fax: (985) 446-2189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence MD.308148 (LA)

Record details

NPI number1992125355
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 23, 2014
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026
Mailing address506 N Acadia Rd, Thibodaux, LA 70301-4862

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 2013 (13 years in practice)
Group practice Thibodaux Regional Network Development Corporation — 135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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