Broadwell, Larry K
Broadwell, Larry K is an individual health care provider with primary practice located at 820 Jordan St Suite 201, Shreveport LA 71101-4518. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Broadwell, Larry K can be contacted via phone (318) 221-0399.Contact Information
Primary practice address
820 Jordan St Suite 201
Shreveport LA 71101-4518
Phone: (318) 221-0399
Fax: (318) 221-1940
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 013598 | Louisiana |
Profile Details
| NPI number | 1326194036 |
|---|---|
| LBN Legal business name | Broadwell, Larry K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2007 |
| Last updated | Nov 16th, 2007 - about 19 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 | 1326194036 | NPPES |
| Louisiana | MEDICAID | 1303429 |
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