Broussard, Jeffrey K.

Broussard, Jeffrey K. is an individual health care provider with primary practice located at 501 20Th St Suite 606, Knoxville TN 37916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Broussard, Jeffrey K. can be contacted via phone (865) 546-8040.

Contact Information

Primary practice address
501 20Th St Suite 606 Knoxville TN 37916
Phone: (865) 546-8040
Fax: (865) 541-2787
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 27390 Tennessee

Profile Details

NPI number 1790776482
LBN Legal business name Broussard, Jeffrey K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated May 18th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790776482 NPPES
Tennessee Other 100021071 PHP TENNCARE
Tennessee Other 4087786 PHP TENNCARE
Tennessee MEDICAID 3806937 PHP TENNCARE
Tennessee Other 4087786 PHP TENNCARE
Tennessee Other P00154870 PHP TENNCARE

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