IndividualActive
Gerald Broussard, MD
NPI 1104117688 · Diagnostic Radiology Physician · Hattiesburg, MS
Provider details
- NPI number
- 1104117688
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- R2826 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Student, Health Care
Allopathic & Osteopathic Physicians
Practice location
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone: (800) 494-8260
Fax: (859) 368-0437
Approximate (ZIP-level) locationGet directions
Mailing address
5000 W 4th St
Hattiesburg, MS 39402-1000
Additional practice locations (1)
- 178 Highway 24 ECentreville, MS 39631-4171Phone: (601) 890-0500Fax: (601) 645-5873
Registry dates
- Enumerated
- 2011-05-02
- Last updated
- 2026-05-06
- Certified
- 2026-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.