Doctor Name: | DR. LAUREL EVANS BROADHURST |
NPI Number: | 1669590055 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 009501185 |
Business Practice Address: | 201 Tabernacle Rd Jfk-adatc Black Mountain, NC - 287112526 |
Business Phone Number: | 8286693455 |
Business Fax Number: | |
Mailing Address: | 1000s Sterling St, MORGANTON |
State: | NC |
Postal Code: | 286553938 |
Phone Number: | 8284332566 |
Fax Number: | 8284332242 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 009501185 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |