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JODY MACK BROUSSARD
NPI 1659871796
Driver in Deridder, LA

Active since February 15, 2018
494 OTTO FRANKLIN RD, DERIDDER, LA 70634(337) 396-1312(337) 462-0283 Get Directions Write a Review

NPPES record last updated: February 15, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jody Mack Broussard NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JODY MACK BROUSSARD (NPI 1659871796) is an individual driver provider in Deridder, Louisiana, licensed in Louisiana (005855942) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1659871796
Entity TypeIndividualMale
Primary Taxonomy172A00000X
Provider Legal NameJODY MACK BROUSSARD
Location Address494 OTTO FRANKLIN RDDeridder, LA 70634-6404
Mailing Address494 Otto Franklin RdDeridder, LA 70634-6404 · (337) 396-1312 · Fax (337) 462-0283
Phone(337) 396-1312
Fax(337) 462-0283
Sole ProprietorYes
Enumeration DateFebruary 15, 2018
✔ NPI 1659871796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDriverOther Service Providers
Taxonomy Code172A00000X
License✔ Licensed in LA · 005855942
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
494 OTTO FRANKLIN RD, Deridder, LA 70634
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jody Broussard's NPI number?

The NPI number for Jody Broussard is 1659871796. It was assigned to this individual provider in the NPPES registry on February 15, 2018.

Where is Jody Broussard located?

Jody Broussard practices at 494 Otto Franklin Rd, Deridder, LA 70634. The listed phone number is (337) 396-1312.

What is Jody Broussard's specialty?

The primary specialty registered for this NPI is Driver with taxonomy code 172A00000X.

When was this NPI record last updated?

The NPPES record for Jody Broussard was last updated on February 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.