Organization
Y. YOKO BROUSSARD MD, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. Y YOKO BROUSSARD MD (OWNER)
(337) 439-2200
Entity
Organization
Contact information
Practice address
711 DR. MICHAEL DEBAKEY DRIVE, STE400, LAKE CHARLES, LA 70601
(337) 439-2200
(337) 439-4484
Mailing address
711 DR. MICHAEL DEBAKEY DRIVE, STE400, LAKE CHARLES, LA 70601
(337) 439-2200
(337) 439-4484
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
022167
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1483320
—
LA
Enumeration date
01/13/2009
Last updated
01/13/2009
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