Individual
DR. ALAN P. BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100B CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
(337) 261-5151
Mailing address
100B CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
(337) 261-5151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
022215
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1674133
—
LA
01
—
P00185378
RAILROAD MEDICARE
LA
Enumeration date
10/07/2005
Last updated
10/22/2007
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