Dr. Heath Jude Broussard II, DO
Emergency Medicine in Hattiesburg, MS. Individual provider (NPI-1).
NPI number1497217608
StatusActive
Last updated in NPPESFeb 27, 2025
Details
- NPI
- 1497217608
- Entity type
- Individual (NPI-1)
- Name
- Dr. Heath Jude Broussard II
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 5, 2019
- Certification date
- Feb 27, 2025
- Last updated
- Feb 27, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - INTERNAL MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 5435 | TN | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
5001 Hardy StHattiesburg, MS 39402-1308
Phone 601-296-3963
Mailing address
5001 Hardy StHattiesburg, MS 39402-1308
Other practice locations
5001 Hardy St
Hattiesburg, MS 39402
Hattiesburg, MS 39402
Phone 601-296-3963
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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