DR. BLAINE MARK BROUSSARD (NPI# 1023251659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023251659 |
| Entity Type | Individual |
| Full Name | DR. BLAINE MARK BROUSSARD |
| Credential | M.D. |
| Practice Address |
176 Versailles Blvd Alexandria LA 71303-2493 |
| Mailing Address |
Po Box 13030 Alexandria LA 71315-3030 |
| Practice Telephone | 3184459331 |
| Practice Fax Number | 3186196899 |
| Mailing Telephone | 3184459331 |
| Mailing Fax Number | 3186196899 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 206014 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 206014 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2339605 | 05 |
| Street Address |
176 VERSAILLES BLVD |
| City | ALEXANDRIA |
| State | LA |
| Zip Code | 71303-2493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346233293 | Jose Ramon Garcia-ramirez | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2005-08-25 |
| 1578964714 | Bridgette Marcotte | Nurse Practitioner | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2014-09-08 |
| 1902226285 | Bridgett Dawn Foreman | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2014-04-24 |
| 1255668760 | Kaitlin Harris Miller | Nurse Practitioner | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2009-11-05 |
| 1770780108 | Aaron David Mclemore | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2007-06-29 |
| 1316043730 | Daniel Renois | Family Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2006-09-15 |
| 1780627000 | Roberto Jose Garcia | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2006-06-14 |
| 1831180637 | Freedman Clinic of Internal Medicine, LLP | Family Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2005-10-31 |
| 1326035122 | Ernesto Jose Garcia-ramos | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2005-10-05 |
| 1831182781 | Hong Yang Liu | Internal Medicine | 176 Versailles Blvd, Alexandria, LA 71303-2493 | 2005-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346877370 | Victoria Bowie | Peer Specialist | 1405 Peterman Drive Suite A, Alexandria, LA 71303 | 2020-03-27 |
| 1396375051 | Christin Authement | Social Worker | 8326 Kelwood Avenue, Alexandria, LA 71303 | 2020-01-22 |
| 1164904520 | Carissa A Sorenson | Pharmacist | 4448 Jackson St, Alexandria, LA 71303 | 2018-09-02 |
| 1144731027 | Bradly Herman | Counselor | 1450 Peterman Drive, Alexandria, LA 71303 | 2017-10-18 |
| 1669991915 | Rashika Holmes | Counselor | 1538 Chase Dr, Alexandria, LA 71303 | 2017-09-18 |
| 1215466594 | Terraniecya Shepherd | Case Manager/Care Coordinator | 700 Veterans Dr. Apt. 608, Alexandria, LA 71303 | 2017-06-08 |
| 1427587864 | Jason Micheal Lachica | Counselor | 3921 Indpendence Drive Ste 104, Alexandria, LA 71303 | 2017-06-08 |
| 1669929188 | Ryan Knoll | Chiropractor | 5419 Jackson St. Ext. Suite B, Alexandria, LA 71303 | 2016-09-01 |
| 1023464393 | Heart of Hospice, LLC | Hospice Care, Community Based | 1001 Bayou Pl, Alexandria, LA 71303 | 2016-05-05 |
| 1770947764 | Jiquiah White | Counselor | 2016 Innis Dr, Alexandria, LA 71303 | 2016-04-06 |
| Find all providers in zip 71303 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588277396 | Amm Consulting Inc | Internal Medicine | 6123 Stegen Dr, Alexandria, VA 22310-2277 | 2020-08-31 |
| 1750814109 | Ajita Acharya | Internal Medicine | 1800 N Beauregard St Ste 100, Alexandria, VA 22311-1726 | 2017-04-04 |
| 1689121709 | Mid Atlantic Medical Management, LLC | Internal Medicine | 5904 Old Richmond Highway, Suite 515, Alexandria, VA 22303 | 2016-09-07 |
| 1447649462 | Metro Medical Services, LLC | Internal Medicine | 6179 Grovedale Ct Ste 100, Alexandria, VA 22310-2553 | 2015-01-14 |
| 1225438385 | Globa'll Primary Care & Internal Medicine, P.C. | Internal Medicine | 50 Pickett Street, Suite 221, Alexandria, VA 22304-4708 | 2014-08-26 |
| 1982014171 | Sara Wasim | Internal Medicine | 1600 N Beauregard St Ste 300, Alexandria, VA 22311-1732 | 2014-04-28 |
| 1811239627 | Capital Healthcare PC | Internal Medicine | 6020 Richmond Hwy Ste 102, Alexandria, VA 22303-2157 | 2013-03-19 |
| 1558624619 | Yonis B Geberemariam | Internal Medicine | 5375 Duke St Apt 1103, Alexandria, VA 22304-3018 | 2012-06-22 |
| 1639439334 | Sharmila P Dhulipalla | Internal Medicine | 100 S Van Dorn St, Apt C-219, Alexandria, VA 22304-4341 | 2012-05-29 |
| 1821377458 | Werksew Tesfaye Turi | Internal Medicine | 750 Port St Apt 706, Alexandria, VA 22314-2485 | 2011-08-14 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 71303 |
Please comment or provide details below to improve the information on DR. BLAINE MARK BROUSSARD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.