Broussard, Marlene Marie
Broussard, Marlene Marie is an individual health care provider with primary practice located at 1501 Kings Hwy Department Of Pediatrics, Shreveport LA 71103-4228. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Broussard, Marlene Marie can be contacted via phone (318) 675-8600.Contact Information
Primary practice address
1501 Kings Hwy Department Of Pediatrics
Shreveport LA 71103-4228
Phone: (318) 675-8600
Fax: (318) 675-8638
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 024730 | Louisiana |
Profile Details
| NPI number | 1144240011 |
|---|---|
| LBN Legal business name | Broussard, Marlene Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Jul 9th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144240011 | NPPES |
| Louisiana | MEDICAID | 1577995 |
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