HEATH BROUSSARD (NPI# 1801881958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801881958 |
| Entity Type | Individual |
| Full Name | HEATH BROUSSARD |
| Credential | MD |
| Practice Address |
700 W Forest Ave Ste 300 Jackson TN 38301-3937 |
| Mailing Address |
Po Box 400 Jackson TN 38302-0400 |
| Practice Telephone | 7314220310 |
| Practice Fax Number | 7314220440 |
| Mailing Telephone | 7314238697 |
| Mailing Fax Number | 7314225743 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2012-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 31232 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3832620 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497217608 | Heath Jude Broussard II | Student in an Organized Health Care Education/Training Program | 5001 Hardy St, Hattiesburg, MS 39402-1308 | 2019-04-05 |
| Street Address |
700 W FOREST AVE STE 300 |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659723823 | Jennifer S Mcfarland | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2016-07-12 |
| 1164767133 | Lisa Jewel Alexander Nwokolo | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2012-12-03 |
| 1487970497 | William Charles Barrow | Psychiatry & Neurology | 700 W Forest Ave, Ste 200, Jackson, TN 38301-3937 | 2010-04-15 |
| 1033448642 | Amanda Caroline Holley | Audiologist | 700 W Forest Ave, Ste. 300, Jackson, TN 38301-3937 | 2009-12-10 |
| 1275868390 | West Tennessee Medical Group Inc | Durable Medical Equipment & Medical Supplies | 700 W Forest Ave, Suite 200, Jackson, TN 38301-3937 | 2009-10-07 |
| 1689816142 | Timothy Philip Love | Surgery | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-03-30 |
| 1407092836 | Margaret J Spragins | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-01-07 |
| 1063675692 | Fausta Ditah | Internal Medicine | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-07-03 |
| 1760653505 | Timothy Chad Davenport | Urology | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-03-20 |
| 1356528442 | Shahzad Shah | Internal Medicine | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| 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 |
|---|---|---|---|---|
| 1851731103 | Zachary James Virgin | Surgery | 300 W Washington Ave Ste 300, Jackson, MI 49201-2160 | 2013-07-01 |
| 1407290372 | Derek S. Palmer | Surgery | 120 District Blvd Apt 433, Jackson, MS 39211-6389 | 2013-04-23 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1639419997 | Fred Silvestri Md, LLC | Surgery | 4 Long Bay Rd, Jackson, NJ 08527-2662 | 2013-02-25 |
| 1528356482 | James P. Spell | Surgery | 21 Lamplighter Rd., Jackson, MS 39208 | 2011-07-13 |
| 1629371018 | Richard L Yelverton Md Pa | Surgery | 1040 River Oaks Dr Ste 102, Jackson, MS 39232-9539 | 2010-12-07 |
| 1619125952 | Otha Edward Williams Jr. | Surgery | 1736 Lake Trace Dr, Jackson, MS 39211-3353 | 2008-08-28 |
| 1770604803 | Rajesh Kuruba | Surgery | 1500 E Woodrow Wilson Ave., Jackson, MS 39216-5199 | 2007-04-03 |
| 1679692396 | Reginald Willis Martin | Surgery | 971 Lakeland Dr Ste 211, Jackson, MS 39216-4607 | 2007-03-28 |
| 1295878783 | P George Poore | Surgery | 555 East Broadway Ste 212, Jackson, WY 83001-4777 | 2007-02-14 |
| Find all providers in JACKSON | ||||
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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.