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Individual
DR. EMMETT J. BROADDUS
Active
Individual
DR. EMMETT J. BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
26593
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000227076
ANTHEM BLUE CROSS
KY
01
—
110239071
RAILROAD MEDICARE
KY
01
—
1167181
PASSPORT
KY
05
—
64265937
—
KY
Enumeration date
03/16/2006
Last updated
06/17/2010
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