Individual
BRETT LOUIS BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
BANNER BOSWELL SURGICAL ONCOLOGY, 13188 N. 103RD DRIVE, SUITE 200, SUN CITY, AZ 85351
(623) 832-3444
(623) 832-3470
Mailing address
BANNER BOSWELL SURGICAL ONCOLOGY, 13188 N. 103RD DRIVE, SUITE 200, SUN CITY, AZ 85351
(623) 832-3444
(623) 832-3470
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
56911
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2009
Last updated
02/05/2020
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