# YOUNG EYE CLINIC, A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073550448
- **Authorized official:** EMILE D BROUSSARD MD (OWNER)
- **Authorized official phone:** (337) 893-4452

## Contact information

- **Practice address:** 204 N MAGDALEN SQ, ABBEVILLE, LA 70510-4645
- **Practice address phone:** (337) 893-4452
- **Practice address fax:** (337) 893-7870
- **Mailing address:** 204 N MAGDALEN SQ, ABBEVILLE, LA 70510-4645
- **Mailing address phone:** (337) 893-4452
- **Mailing address fax:** (337) 893-7870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 06/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0583490001 | DME | LA |