MS. LUCY BROADDUS, MMS, PA-C, ATC.

Physician Assistant

Active Individual
NPI: 1114299419

Practice Address

310 N 7 HILLS RD STE 220
O Fallon, IL 62269

Phone: (618) 624-6181

Specialties

Specialty Code Primary License
Physician Assistant 363A00000X Yes 085004281 (IL)

Frequently Asked Questions

NPI 1114299419 is the National Provider Identifier for MS. LUCY BROADDUS, MMS, PA-C, ATC., a Physician Assistant provider located in O Fallon, IL. This NPI was enumerated on February 1, 2012.
MS. LUCY BROADDUS, MMS, PA-C, ATC. practices at 310 N 7 HILLS RD STE 220, O Fallon, IL 62269.

Quick Facts

NPI
1114299419
Type
Individual
Enumerated
Feb 1, 2012
Last Updated
Jan 26, 2026

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