DR. TOBY D BROUSSARD (NPI# 1770587636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770587636 |
| Entity Type | Individual |
| Full Name | DR. TOBY D BROUSSARD |
| Credential | M.D. |
| Practice Address |
1800 Renaissance Blvd 2nd Floor Edmond OK 73013-3023 |
| Mailing Address |
1800 Renaissance Blvd Edmond OK 73013-3023 |
| Practice Telephone | 4053592473 |
| Mailing Telephone | 4053592473 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2011-06-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 24881 | OK | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 20450 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1989592 | 05 |
| Street Address |
1800 RENAISSANCE BLVD 2ND FLOOR |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083273932 | Jennifer Wu | Registered Nurse | 1800 Renaissance Blvd, Edmond, OK 73013-3023 | 2019-06-12 |
| 1003354689 | Memorial Hospital of Texas County Authority | Orthopaedic Surgery | 1800 Renaissance Blvd, Second Floor Tower, Suite 210, Edmond, OK 73013-3023 | 2017-02-03 |
| 1184179988 | Zeiders Orthopedics Pllc | Orthopaedic Surgery | 1800 Renaissance Blvd, Suite 210, Edmond, OK 73013-3023 | 2016-08-22 |
| 1437492436 | Melisa Weaver Aprn - Cnp Pllc | Nurse Practitioner | 1800 Renaissance Blvd, Suite 200, Edmond, OK 73013-3023 | 2013-03-28 |
| 1881935922 | Sheridan Anesthesia Services of Oklahoma, Inc | Anesthesiology | 1800 Renaissance Blvd, Edmond, OK 73013-3023 | 2013-03-14 |
| 1740578103 | Dianne Genene Tupper | Registered Nurse | 1800 Renaissance Blvd, Edmond, OK 73013-3023 | 2011-07-19 |
| 1225260565 | Jim R. Keller, Ph.d., Specialists In Psychological Counseling & Consul | Psychologist | 1800 Renaissance Blvd, 2nd Floor, Edmond, OK 73013-3023 | 2009-08-20 |
| 1982838876 | Jennifer Marie Cooper | Specialist/Technologist | 1800 Renaissance Blvd, Edmond, OK 73013-3023 | 2009-05-07 |
| 1821231929 | Tupper Orthopedics Pllc | Orthopaedic Surgery | 1800 Renaissance Blvd, Suite 200, Edmond, OK 73013-3023 | 2009-04-20 |
| 1316123912 | Foundation Weightwise Services, LLC | Psychologist | 1800 Renaissance Blvd, Second Floor, Edmond, OK 73013-3023 | 2008-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396072344 | Big Blue Star LLC | Surgery | 1800 Renaissance Blvd Ste 200, Edmond, OK 73013-3023 | 2009-11-12 |
| 1902946486 | Aimee Levy | Surgery | 4833 Integris Pkwy Ste 350, Edmond, OK 73034 | 2007-02-07 |
| 1295726719 | Joshua P Carey | Surgery | 4833 Integris Pkwy, Suite 350, Edmond, OK 73034 | 2005-11-03 |
| 1861494015 | Charles M Gelnar | Surgery | 105 S Bryant Ave, #104, Edmond, OK 73034-6330 | 2005-06-01 |
| 1770917353 | Philip C Bryan Md Pllc | Surgery | 2204 Rambling Rd, Edmond, OK 73025-2310 | 2013-08-30 |
| 1992841811 | General Surgery Group, Pllc | Surgery | 1800 Renaissance Blvd, 2nd Floor, Edmond, OK 73013-3023 | 2007-01-29 |
| 1689729907 | Transforming Lives Pllc | Surgery | 1800 Renaissance Blvd, Second Floor, Edmond, OK 73013-3023 | 2007-01-25 |
| 1205856820 | Stephen W Mihalsky | Surgery | 105 S Bryant Ave, Suite 407, Edmond, OK 73034-6399 | 2006-07-19 |
| 1750316949 | Gregory F Walton | Surgery | 1800 Renaissance Blvd, 2nd Floor, Edmond, OK 73013-3023 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702127 | Advanced Surgical Assisting, LLC | Surgery | 4012 E 108th St, Tulsa, OK 74137-6707 | 2020-05-20 |
| 1639642655 | Okc Surgicalists Pllc | Surgery | 4140 W Memorial Rd Ste 408, Oklahoma City, OK 73120-8300 | 2019-01-03 |
| 1376016329 | Oklahoma Acute Care Surgical Specialists LLC | Surgery | 4016 E 27th St, Tulsa, OK 74114-5908 | 2019-01-02 |
| 1265907885 | Apex Surgery Center, LLC | Surgery | 2001 Cradduck Road, Ada, OK 74820 | 2018-10-10 |
| 1588107957 | Elias Cardiovascular Disease Pllc | Surgery | 1104 E State Highway 152 Unit 2, Mustang, OK 73064-5116 | 2016-12-02 |
| 1831540608 | Eric Waetjen | Surgery | 4502 E 51st St, 2g06, Tulsa, OK 74135-3702 | 2016-06-23 |
| 1811381247 | Mohamad Sidani | Surgery | 800 Stanton L Young Blvd # 9432, Oklahoma City, OK 73104-5018 | 2015-03-24 |
| 1336554880 | Alex Jones | Surgery | 500 E Robinson St Ste 1300, Norman, OK 73071-6694 | 2014-06-24 |
| 1396159596 | Paul Mcgaha II | Surgery | 10920 Sw 30th Ter, Yukon, OK 73099-0435 | 2014-06-16 |
| 1154747053 | Haley Adams | Surgery | 115 W 13th St, Grove, OK 74344-3224 | 2014-03-15 |
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| 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.