Individual
MR. JEFFREY K. BROUSSARD
Active
Individual
MR. JEFFREY K. BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27390
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100021071
PHP TENNCARE
TN
05
—
3806937
—
TN
01
—
4087786
BLUECARE
TN
01
—
P00154870
TRAVELERS MEDICARE
TN
Enumeration date
11/02/2005
Last updated
05/18/2018
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