Doctor Name: | JEROME MICHAEL BROUSSARD |
NPI Number: | 1699775783 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 014713 |
Business Practice Address: | 4640 Ambassador Caffery Pkwy Lafayette, LA - 705086902 |
Business Phone Number: | 3379841050 |
Business Fax Number: | 3379848776 |
Mailing Address: | 4640 Ambassador Caffery Pkwy, LAFAYETTE |
State: | LA |
Postal Code: | 705086902 |
Phone Number: | 3379841050 |
Fax Number: | 3379848776 |
NPI Enumeration Date: | 07/29/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 014713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |