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Organization
YOUNG EYE CLINIC, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
YOUNG EYE CLINIC, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILE D BROUSSARD MD (OWNER)
(337) 893-4452
Entity
Organization
Contact information
Practice address
204 N MAGDALEN SQ, ABBEVILLE, LA 70510-4645
(337) 893-4452
(337) 893-7870
Mailing address
204 N MAGDALEN SQ, ABBEVILLE, LA 70510-4645
(337) 893-4452
(337) 893-7870
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0583490001
DME
LA
Enumeration date
06/02/2006
Last updated
06/09/2015
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