Broussard, Bradley James

Broussard, Bradley James is an individual health care provider with primary practice located at 4140 Ferncreek Dr Suite 801, Fayetteville NC 28314-2563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Broussard, Bradley James can be contacted via phone (910) 484-2171.

Contact Information

Primary practice address
4140 Ferncreek Dr Suite 801 Fayetteville NC 28314-2563
Phone: (910) 484-2171
Fax: (910) 484-4568
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 9600467 North Carolina

Profile Details

NPI number 1457325110
LBN Legal business name Broussard, Bradley James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Oct 3rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457325110 NPPES
North Carolina MEDICAID 8918801
North Carolina Other 18801

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