Individual Healthcare Provider
Gerald B Broussard, MD
Provider's NPPES record last updated: May 6, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1104117688
- Primary Specialty
- Radiology — Diagnostic Radiology
- Practice Location
- Hattiesburg, Mississippi
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 11:53 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Radiology
Diagnostic Radiology
Allopathic & Osteopathic Physicians
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Taxonomy code 2085R0202X Student in an Organized Health Care Education/Training Program
Student, Health Care
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Taxonomy code 390200000XInternal Medicine
Addiction Medicine
Allopathic & Osteopathic Physicians
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Taxonomy code 207RA0401X
Provider-Reported License Information
- Radiology (Mississippi)
- 24982
- Radiology (Kentucky)
- R2826
- Internal Medicine (Kentucky)
- R2826
Practice Locations
Practice Location
6051 U S Highway 49
Hattiesburg, Mississippi 39401-7200
Phone: (800) 494-8260
Additional Practice Location
178 Highway 24 E
Centreville, Mississippi 39631-4171
Phone: (601) 890-0500
Fax: (601) 645-5873
Record Information
- Enumeration Date
- May 2, 2011
- Provider's NPPES Record Last Updated
- May 6, 2026
- Certification Date
- May 6, 2026
- NPISignal NPPES Dataset
- August 2026
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