| Dr Toby D Broussard, MD | |
|
1800 Renaissance Blvd, 2nd Floor, Edmond, OK 73013-3023 | |
| (405) 359-2473 | |
| Not Available |
| Full Name | Dr Toby D Broussard |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 36 Years |
| Location | 1800 Renaissance Blvd, Edmond, Oklahoma |
| 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 |
|---|---|---|---|
| 1770587636 | NPI | - | NPPES |
| 1989592 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 20450 (Louisiana) | Secondary |
| 208600000X | Surgery | 24881 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Summit Medical Center | Edmond, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Transforming Lives Pllc | 2264621507 | 2 |
| Entity Name | Transforming Lives Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689729907 PECOS PAC ID: 2264621507 Enrollment ID: O20110118000821 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Toby D Broussard, MD 1800 Renaissance Blvd, Edmond, OK 73013-3023 Ph: (405) 359-2473 | Dr Toby D Broussard, MD 1800 Renaissance Blvd, 2nd Floor, Edmond, OK 73013-3023 Ph: (405) 359-2473 |
Stephen W Mihalsky, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 105 S Bryant Ave, Suite 407, Edmond, OK 73034 Phone: 405-348-5060 Fax: 405-348-7508 | |
Joshua P Carey, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4833 Integris Pkwy, Suite 350, Edmond, OK 73034 Phone: 405-657-3690 Fax: 405-552-5143 | |
Dr. Carl J Gilbert, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4509 Integris Pkwy, Edmond, OK 73034 Phone: 405-657-3195 Fax: 405-657-3193 | |
Dr. Sylvia Susana Gray, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2017 W I 35 Frontage Rd Ste 250, Edmond, OK 73013 Phone: 405-757-3340 Fax: 405-757-3341 | |
Dr. Ernestine Carol Shires, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3325 S Boulevard Ste 113, Edmond, OK 73013 Phone: 405-330-7000 | |
Matthew Tyler Marr, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4509 Integris Pkwy Ste 300, Edmond, OK 73034 Phone: 405-657-3704 Fax: 405-657-3892 | |
Dr. Larry E Adams, MD Surgery Medicare: Medicare Enrolled Practice Location: 5809 Havenshire Ln, Edmond, OK 73034 Phone: 580-421-5815 |