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
Fax: (318) 675-8638
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1144240011 NPPES
Louisiana MEDICAID 1577995

Popular Providers