| Andre Paul Broussard, MD | |
|
1501 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 675-5053 | |
| Not Available |
| Full Name | Andre Paul Broussard |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 15 Years |
| Location | 1501 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407147291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 300911 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| First Option Home Health | Lafayette, LA | Home health agency |
| Iberia Medical Center | New iberia, LA | Hospital |
| Our Lady Of Lourdes Regional Medical Center, Inc | Lafayette, LA | Hospital |
| Park Place Surgical Hospital | Lafayette, LA | Hospital |
| Lafayette General Medical Center | Lafayette, LA | Hospital |
| Franklin Foundation Hospital | Franklin, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Urology Llc | 5597833772 | 27 |
| Entity Name | Lsuhn Billing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992975775 PECOS PAC ID: 0446337802 Enrollment ID: O20080409000372 |
| Entity Name | Southern Urology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740441955 PECOS PAC ID: 5597833772 Enrollment ID: O20081002000001 |
| Mailing Address | Practice Location Address |
|---|---|
| Andre Paul Broussard, MD 120 Rue Louis Xiv, Lafayette, LA 70508-5739 Ph: (337) 769-7779 | Andre Paul Broussard, MD 1501 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 675-5053 |
Ralph Jonathan Henderson, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 255 Bert Kouns, Shreveport, LA 71106 Phone: 318-683-0411 Fax: 318-603-5461 | |
Dennis Dale Venable, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Department Of Urology, Shreveport, LA 71103 Phone: 318-813-2750 Fax: 318-813-2755 | |
Alison Smith Spann, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 255 Bert Kouns Industrial Loop, Shreveport, LA 71106 Phone: 318-683-0411 Fax: 318-688-8525 | |
Raymond Wendell Turner, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 9854 Jennifer Ln, Shreveport, LA 71106 Phone: 318-797-5786 | |
Dr. Tajammul N Fazili, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-221-8411 | |
Mrs. Ashley Sittig Baker, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 255 Bert Kouns, Shreveport, LA 71106 Phone: 318-683-0411 Fax: 318-603-5461 |