| NPI | 1023251659 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2009-04-13 |
| Last Updated | 2022-05-24 |
| Mailing Address | Po Box 13030 Alexandria, LA 71315-3030 United States Phone: (318) 445-9331 | Fax: (318) 619-6899 📍 View Map |
| Primary Practice Address | 176 Versailles Blvd Alexandria, LA 71303-2493 United States Phone: (318) 445-9331 | Fax: (318) 619-6899 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | LA | 2339605 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 208000000X – Pediatrics | LA | 206014 |
| Yes | 207R00000X – Internal Medicine | LA | 206014 |
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About NPI 1023251659
Blaine Mark Broussard M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1023251659. The primary specialty listed is Internal Medicine. The provider is located in Alexandria, LA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2009-04-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1023251659?
NPI 1023251659 belongs to Blaine Mark Broussard M.D., a Internal Medicine in Alexandria, LA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1023251659 active?
The current status of NPI 1023251659 in the NPPES registry is Active. The record was last updated on 2022-05-24.
What specialty is NPI 1023251659?
NPI 1023251659 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1023251659?
You can verify NPI 1023251659 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1023251659?
The primary practice address on file for NPI 1023251659 is 176 Versailles Blvd, Alexandria, LA 71303-2493. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1023251659 issued?
NPI 1023251659 was first issued (enumerated) on 2009-04-13. The NPPES record was last updated on 2022-05-24.
Practice Location Map
Blaine Mark Broussard is located at 176 Versailles Blvd, Alexandria, LA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Blaine Mark Broussard. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1023251659. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pediatrics | 206014 | LA |
| Internal Medicine | 206014 | LA |