Individual
RICHARD K. BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
439 HEYMANN BLVD, LAFAYETTE, LA 70503-2616
(337) 269-0963
(337) 269-0553
Mailing address
439 HEYMANN BLVD, LAFAYETTE, LA 70503-2616
(337) 269-0963
(337) 269-0553
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
018918
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100005170
RAIL ROAD MEDICARE NUMBER
LA
05
—
1957356
—
LA
Enumeration date
11/28/2006
Last updated
08/06/2015
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