Dr. Stacy R Broussard, MD
Family Medicine in Saint Peters, Missouri
1932249356- Practice location
- 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386
- Phone
- 636-916-9615
- Fax
- —
- Last updated
- January 13, 2026
Stacy R Broussard is a Family Medicine based in Saint Peters, MO. Stacy R Broussard practices in Saint Peters, MO and has the professional credentials of MD. The NPI Number for Stacy R Broussard is 1932249356 and holds a License No. 25MA06996700 (NJ). The current practice location address for Stacy R Broussard is 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386 and can be reached out via phone at 636-916-9615.
Provider Profile Details
- NPI Number
- 1932249356
- Provider Name
- Stacy R Broussard
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386
- Phone Number
- 636-916-9615
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Other Names
- Dr. Stacy Mevs, MD (Professional Name)
- Provider Enumeration Date
- February 7, 2007
- Last Update Date
- January 13, 2026
- Certification Date
- January 13, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 201 Bjc Saint Peters Dr Ste 200
Saint Peters, MO 63376-3386 - City
- Saint Peters
- State
- Missouri
- Zip
- 63376-3386
- Phone Number
- 636-916-9615
Provider Business Mailing Address Details
- Address
- Po Box 959354
Saint Louis, MO 63195-9354 - City
- Saint Louis
- State
- MO
- Zip
- 63195-9354
- Phone Number
- 636-916-9615
- Fax Number
- 636-916-9850
License Information
- License Number (1)
- 25MA06996700
- License State (1)
- NJ
- Taxonomy (1)
- Family Medicine · 207Q00000X
- License Number (2)
- 2021045311
- License State (2)
- MO
- Taxonomy (2)
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Stacy R Broussard, MD?
The NPI number of Dr. Stacy R Broussard, MD is 1932249356. It was assigned on February 7, 2007 and is currently active in the NPPES registry.
What is the specialty of Dr. Stacy R Broussard, MD?
Dr. Stacy R Broussard, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number 25MA06996700.
Where does Dr. Stacy R Broussard, MD practice?
The practice location is 201 Bjc Saint Peters Dr Ste 200, Saint Peters, MO 63376-3386. The office can be reached at 636-916-9615 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1932249356 directly on the NPPES registry website.