Individual
LOREN E BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-6475
(417) 269-7118
Mailing address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-3465
(417) 269-8189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27567
MO
Other
Enumeration date
03/08/2007
Last updated
11/12/2009
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