Broussard, Brad
Broussard, Brad is an individual health care provider with primary practice located at 155 Hospital Dr. Ste 206 , Lafayette LA 70503. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Broussard, Brad can be contacted via phone (337) 234-3204.Contact Information
Primary practice address
155 Hospital Dr. Ste 206
Lafayette LA 70503
Phone: (337) 234-3204
Fax: (337) 234-3599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M3171 | Texas |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | M3171 | Texas |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | M3171 | Texas |
Profile Details
| NPI number | 1275551509 |
|---|---|
| LBN Legal business name | Broussard, Brad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Sep 4th, 2014 - about 12 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 | 1275551509 | NPPES |
| Other | P00473770 | RR MCR | |
| Other | 8DCN 1365642 TICKET | RR MCR | |
| MEDICAID | 181131701 | RR MCR | |
| Other | 8M1458 | RR MCR |
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