Individual
JASON BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 LINE AVE FL 3, SHREVEPORT, LA 71101-3841
(318) 716-4610
(318) 716-4690
Mailing address
1111 LINE AVE FL 3, SHREVEPORT, LA 71101-3841
(318) 716-4610
(318) 716-4690
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DO.000136
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1079243
—
LA
Enumeration date
05/31/2007
Last updated
10/04/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us