Emile D. Broussard, M.D. Apmc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EMILE D. BROUSSARD, M.D. APMC

Practice address

204 N Magdalen SQ
Abbeville, LA 70510-4645

Phone

(337) 289-8972

Fax

(337) 289-8970

NPI assigned

Oct 9, 2006

Last updated

Oct 1, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emile D. Broussard, MDNPI 1427038744

Title

Owner

Phone

(337) 893-4452

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emile Dore Broussard, MD

  • Ophthalmology Physician
  • Abbeville, LA
  • NPI 1427038744
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1255428496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N. MAGDALEN SQUARE",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705107645",
            "telephone_number": "337-893-4452",
            "fax_number": "337-893-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N MAGDALEN SQ",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705104645",
            "telephone_number": "337-289-8972",
            "fax_number": "337-289-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILE D. BROUSSARD, M.D. APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "EMILE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-893-4452",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00239622",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Abbeville, LA
• Providers in Abbeville, LA by specialty
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.