Heath Broussard (NPI# 1801881958, PAC ID# 7416090790) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1801881958 |
| PAC ID by PECOS | 7416090790 |
| Professional Enrollment ID | I20100209000413 |
| Full Name | Heath Broussard |
| Organization Legal Name | JACKSON CLINIC PA |
| Address |
87 Murray Guard Dr B Jackson TN 38305-3775 |
| Phone Number | 7316641375 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 1994 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 2668376872 |
| Number of Group Practice Members | 173 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440002 | JACKSON-MADISON COUNTY GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 87 Murray Guard Dr, B, Jackson, TN 38305-3775 | 7316641375 | JACKSON CLINIC PA |
| Organization Legal Name | JACKSON CLINIC PA |
| Physicians | 183 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelsey B Dexter | Endocrinology | Jackson Clinic Pa | 2863 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Katherine Wyatt | Nurse Practitioner | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Anna E Burgess | Family Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| John W Baker | Interventional Cardiology | Jackson Clinic Pa | 1700 Woodlawn Ave, Dyersburg, TN 38024-2028 |
| Todd A Teague | Internal Medicine | Jackson Clinic Pa | 1863 S Highland Ave, Jackson, TN 38301-7799 |
| Timothy R Crossett | Diagnostic Radiology | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Ernesto P Chioco | Internal Medicine | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Matthew T Graham | Diagnostic Radiology | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Kellie L Wallace-wilding | Family Medicine | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Faust Ditah | Gastroenterology | Jackson Clinic Pa | 2859 Hwy 45 Byp, Jackson, TN 38305-3618 |
| Street Address |
87 MURRAY GUARD DR B |
| City | JACKSON |
| State | TN |
| Zip | 38305-3775 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna E Burgess | Family Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Aleruchi Oleru | Internal Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| William B Lofton | Internal Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| William Irvin Mariencheck Jr. | Pulmonary Disease | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Jorge N Glass | Pulmonary Disease | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| John Sparrow | Plastic and Reconstructive Surgery | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Bryan P Tygart | Internal Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Osayawe N Odeh | Internal Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Evanna Proctor | Internal Medicine | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Lolly Eldridge | Obstetrics/gynecology | Jackson Clinic Pa | 87 Murray Guard Dr, B, Jackson, TN 38305-3775 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Pickering | Psychologist, Clinical | 367 B N Pkwy, Suite 1, Jackson, TN 38305 | |
| Tammy M Griffis | Nurse Practitioner | Primary Care Clinic of Jackson | 1430 Union University Dr, Suite B, Jackson, TN 38305-0001 |
| Kathy M O'connor-wray | Nurse Practitioner | Primary Care Clinic of Jackson | 1430 Union University Dr, Suite B, Jackson, TN 38305-0001 |
| Rebecca Ann Hamilton | Nurse Practitioner | Northside Medical Clinic, P.C. | 31 Hughes Dr, Jackson, TN 38305-1505 |
| Elizabeth S Londino | Family Medicine | Northside Medical Clinic, P.C. | 31 Hughes Dr, Jackson, TN 38305-1505 |
| Marion J Scott | Nurse Practitioner | Northside Medical Clinic, P.C. | 31 Hughes Dr, Jackson, TN 38305-1505 |
| Timothy W Hayden | Family Medicine | Northside Medical Clinic, P.C. | 31 Hughes Dr, Jackson, TN 38305-1505 |
| Diane H Wright | Clinical Social Worker | Starting Place LLC | 180 W University Pkwy H, Jackson, TN 38305-1612 |
| Richard Murphy Spring | Psychologist, Clinical | 156 W University Pkwy, Suite B, Jackson, TN 38305-1617 | |
| Steven Anthony Sopcak | Chiropractic | 156 W University Pkwy, Suite A, Jackson, TN 38305-1617 | |
| Find all physicians in zip 38305 | |||
| City | JACKSON |
| Zip Code | 38305 |
| Specialty | GENERAL SURGERY |
| City + Specialty | JACKSON + GENERAL SURGERY |
Please comment or provide details below to improve the information on Heath Broussard.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.