Male or Other

Dr. Gary Broadnax MD

Specialist in Augusta, GA(View on Map)

Full Name

Dr. Gary Broadnax MD

NPI Number

1033278361

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/06/2006

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

1289 BROAD STREET
1289 BROAD ST

City

Augusta
Augusta

State

GA
GA

Postal Code

30901
30901-1187

Country

US
US

Telephone Number

(404) 688-9305
(706) 724-5557

Identifiers

Identifier

586045874
586045874
586045874
586045874
586045874
586045874
586045874
G16213

Identifier State

GA
GA
GA
GA
Unknown
Unknown
GA
SC

Identifier Issuer

PEACHSTATE HEALTH PLAN
CIGNA HEALTHCARE
BCBS OF GEORGIA
AMERIGROUP COMMUNITY CARE
AETNA HEALTHCARE
HUMANA
UNITED HEALTHCARE
SOUTH CAROLINA MEDICAID

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/12/2010

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