Gerald Ball Broussard MD

NPI 1073511903 - Ophthalmology - 207W00000X

NPI Details
NPI 1073511903
Gender Male
Enumeration Date 07/13/2005
Last Updated 07/09/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1250 PECANLAND RD
SUITE E-1
MONROE LA, 71203-7011, US
Phone (318) 387-2015
Fax (318) 387-2097
Business Location
1250 PECANLAND RD
SUITE E-1
MONROE LA, 71203-7011, US
Phone (318) 387-2015
Fax (318) 387-2097
Toxanomy
Taxonomy Code 207W00000X
License State Louisiana
License Number 014616
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According to our database, Dr. Gerald Ball Broussard MD NPI is 1073511903, taxonomy code is 207W00000X and license number is 014616, license state is located at Louisiana. Gerald Ball Broussard MD physically located at 1250 Pecanland Rd, Monroe LA, 71203-7011. NPI Number Gerald Ball Broussard MD has the Individual type.

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1073511903 NPI number is provided on an as is basis without warranty of any kind. 1073511903 is maintained by the National Plan & Provider Enumeration System. The contents of Gerald Ball Broussard MD are for informational purposes only.