MR. Malcolm J Broussard

NPI #1346241007 in Baton Rouge, Louisiana

Provider Information

NPI Number: 1346241007
Entity Type: Individual
Name: MR. Malcolm J Broussard
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Aug 3, 2005
Last Updated: Apr 7, 2011

Practice Location

Address: 3388 BRENTWOOD DR
City: Baton Rouge
State: Louisiana
ZIP Code: 70809-1700
Phone: (225) 925-6481

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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