GERALD BROUSSARD JR., MD
Radiology - Diagnostic Radiology
Active
Individual
NPI: 1104117688
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Internal Medicine - Addiction Medicine | 207RA0401X | No | R2826 (KY) |
| Radiology - Diagnostic Radiology | 2085R0202X | Yes | 24982 (MS) |
| Student in an Organized Health Care Education/Training Program | 390200000X | No | - |
Frequently Asked Questions
NPI 1104117688 is the National Provider Identifier for GERALD BROUSSARD JR., MD, a Radiology - Diagnostic Radiology provider located in Hattiesburg, MS. This NPI was enumerated on May 2, 2011.
GERALD BROUSSARD JR., MD practices at 6051 U S HIGHWAY 49, Hattiesburg, MS 39401.
Quick Facts
- NPI
- 1104117688
- Type
- Individual
- Enumerated
- May 2, 2011
- Last Updated
- Jul 21, 2022
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