Dr Issac Duane Broussard, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Mccomb, Mississippi. His current practice location is
305 Rawls Dr, Mccomb, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 684-0465.
Dr Issac Duane Broussard is licensed to practice in Mississippi (license number 12940) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942272513.
Physician's Profile
Full Name | Dr Issac Duane Broussard |
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Gender | Male |
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Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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Location | 305 Rawls Dr, Mccomb, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1942272513
- Provider Enumeration Date: 02/07/2006
- Last Update Date: 01/22/2008
Medicare PECOS Information:
- PECOS PAC ID: 2365475142
- Enrollment ID: I20101027000397
Medical Identifiers
Medical identifiers for Dr Issac Duane Broussard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942272513 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZB0001X | Pathology - Blood Banking & Transfusion Medicine | 12940 (Mississippi) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 12940 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Issac Duane Broussard allows following entities to bill medicare on his behalf.
Entity Name | Burrow Pathology Laboratories Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265744395 PECOS PAC ID: 4688607450 Enrollment ID: O20200722000971 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Issac Duane Broussard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Issac Duane Broussard, MD Po Box 30309, Charleston, SC 29417-0309 Ph: (843) 284-3400 | Dr Issac Duane Broussard, MD 305 Rawls Dr, Mccomb, MS 39648-2833 Ph: (601) 684-0465 |
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