Individual
JULIE M BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 JORDAN ST STE 210, SHREVEPORT, LA 71101-4519
(318) 524-9565
Mailing address
820 JORDAN ST STE 210, SHREVEPORT, LA 71101-4519
(318) 524-9565
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
201006
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21491
—
LA
Enumeration date
05/23/2007
Last updated
02/12/2024
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