NPI 1104117688

Gerald B Broussard, MD

Practitioner Diagnostic Radiology Physician Hattiesburg, MS

Practice location

Address: 6051 U S Highway 49, Hattiesburg, MS 39401-7200
Phone: (800) 494-8260
Fax: (859) 368-0437
Mailing address: 5000 W 4th St, Hattiesburg, MS 39402-1000

Registered specialties (4)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 24982 (MS)

Other Radiology providers in Mississippi →

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence R2826 (KY)

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Mississippi →

Addiction Medicine (Internal Medicine) Physician

Allopathic & Osteopathic Physicians Taxonomy 207RA0401X Licence R2826 (KY)

Other Internal Medicine providers in Mississippi →

Registry record

NPI: 1104117688
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2011
Record last updated: 6 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.