Broussard, Toby D

Broussard, Toby D is an sole proprietor health care provider with primary practice located at 1800 Renaissance Blvd 2Nd Floor, Edmond OK 73013-3023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Broussard, Toby D can be contacted via phone (405) 359-2473.

Contact Information

Primary practice address
1800 Renaissance Blvd 2Nd Floor Edmond OK 73013-3023
Phone: (405) 359-2473
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 20450 Louisiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 24881 Oklahoma

Profile Details

NPI number 1770587636
LBN Legal business name Broussard, Toby D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2005
Last updated Jun 7th, 2011 - about 15 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 1770587636 NPPES
Louisiana MEDICAID 1989592

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