Individual
MR. HAROLD JOSEPH BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2309 E MAIN ST, BLDG B, NEW IBERIA, LA 70560-4046
(337) 560-0931
(337) 560-0934
Mailing address
2309 E MAIN ST, BLDG B, NEW IBERIA, LA 70560-4046
(337) 560-0931
(337) 560-0934
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.A10075.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.A10075.RX
STATE LICENSE NUMBER
LA
Enumeration date
03/12/2007
Last updated
07/08/2007
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