Individual provider · Type 1 NPI

Gerald B. Broussard Jr., MD

Diagnostic Radiology Physician · Hattiesburg, MS

NPI number 1104117688 Active

Practice location

6051 U S Highway 49
Hattiesburg, MS 39401-7200

Call (800) 494-8260 Map

Fax (859) 368-0437

Mailing address

5000 W 4th St
Hattiesburg, MS 39402-1000

Other practice locations

  • 178 Highway 24 E, Centreville, MS 39631-4171 · (601) 890-0500

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202XR2826 (KY)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Addiction Medicine (Internal Medicine) Physician 207RA0401XR2826 (KY)
Diagnostic Radiology Physician Primary 2085R0202X24982 (MS)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1104117688

Gerald B. Broussard Jr., MD's National Provider Identifier is 1104117688, issued on May 2, 2011. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Hattiesburg, MS. The record was last updated on May 6, 2026.