MEDICARE: JOHN BROUSSARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1218	LA
2	2251H1300X	Human Factors Physical Therapist	01218	LA

General Provider Information

NPI Number	:	1063648889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BROUSSARD

Provider Business Mailing Address
First Line	:	620 N MORRISON BLVD STE G
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:	985-543-4113
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 N MORRISON BLVD STE G
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:	985-543-4113
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	12/06/2011

Similar Medicare Providers

1376517219 — MRS. HEATHER DRAGG GAGLIANO LCSW-BACS, ACSW
Practice Location Address:

620 N MORRISON BLVD STE G , LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS
HAMMOND, LA
70401-2312

Practice Phone: 985-543-4109
Practice Fax:

1053485425 — ROBERT MARION KERNE LCSW AND LMFT
Practice Location Address:

620 N MORRISON BLVD , SUITE 4
HAMMOND, LA
70401-2312

Practice Phone: 985-351-3237
Practice Fax:

1316161730 — NEW BEGINNINGS BEHAVIORAL HEALTHCARE INC
Practice Location Address:

620 N MORRISON BLVD STE 7
HAMMOND, LA
70401-2312

Practice Phone: 985-542-9499
Practice Fax: 985-542-9946

1326274143 — HERSCHEL L. BRUNNER PSY.D.
Practice Location Address:

620 N MORRISON BLVD STE G
HAMMOND, LA
70401-2312

Practice Phone: 985-543-4113
Practice Fax:

1891921607 — WANDA L RUSSELL
Practice Location Address:

620 N MORRISON BLVD , SUITE G
HAMMOND, LA
70401-2312

Practice Phone: 985-543-4113
Practice Fax: 985-543-4109

1316173131 — MARY M CASTILLION
Practice Location Address:

620 N MORRISON BLVD STE G
HAMMOND, LA
70401-2312

Practice Phone: 985-543-4113
Practice Fax:

Directions to “ JOHN BROUSSARD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.