Curtis A Broussard
GARDEN PARK PHYSICIAN GROUP INC


Address: 12330 Ashley Dr, Gulfport, MS 39503-2737
Phone: 2282558818

Curtis A Broussard (NPI# 1447248661, PAC ID# 4082634415) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1447248661
PAC ID by PECOS 4082634415
Professional Enrollment ID I20051130000840
Full Name Curtis A Broussard
Organization Legal Name GARDEN PARK PHYSICIAN GROUP INC
Address 12330 Ashley Dr
Gulfport
MS 39503-2737
Phone Number 2282558818
Gender M
Credential MD
Medical School LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduation Year 1979
Primary Specialty FAMILY MEDICINE
Group Practice PAC ID 2264425610
Number of Group Practice Members 3
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
250123 GARDEN PARK MEDICAL CENTER
250007 MERIT HEALTH BILOXI
250019 MEMORIAL HOSPITAL AT GULFPORT

Other Locations

Address Phone Organization
12330 Ashley Dr, Gulfport, MS 39503-2737 2282558818 GARDEN PARK PHYSICIAN GROUP INC

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PHCDRR_1 Immunization Registry Reporting %
ACI_EC_TRANS_PHCDRR_3 Specialized Registry Reporting %
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %

Organization Information

Organization Legal Name GARDEN PARK PHYSICIAN GROUP INC
Physicians 3

Physicians with the same organization

Name Specialty Organization Address
Edwina I Roland Nurse Practitioner Garden Park Physician Group Inc 350 Cowan Rd, Gulfport, MS 39507-2008
Timothy B Skelton Internal Medicine Garden Park Physician Group Inc 15200 Community Rd, Gulfport, MS 39503-3085

Office Location

Street Address 12330 ASHLEY DR
City GULFPORT
State MS
Zip 39503-2737

Physicians in the same zip code

Name Specialty Organization Address
Jonathan Dwaine Brown Orthopedic Surgery Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Clarence Ray Quave Jr. Physical Therapy Encore Rehabilitation Inc 15476 B Dedeaux Rd, Gulfport, MS 39503-2637
Cherryl D Purvis Nurse Practitioner Heart Hypertension Cholesterol and Diabetes Care LLC 15444 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Joseph M Frame Physical Therapy 15444 Dedeaux Rd A, Gulfport, MS 39503-2637
Ricky D Roach Podiatry 15476 Dedeaux Rd, Gulfport, MS 39503-2637
Henry T Leis Orthopedic Surgery Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Ophelia Abrahams Occupational Therapy Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Jason Lowery Physician Assistant Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Eric Jason Graham Orthopedic Surgery Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Nicole Lynn Johnson Nurse Practitioner Bienville Orthopaedic Specialists, LLC 15476 Dedeaux Rd, Suite B, Gulfport, MS 39503-2637
Find all physicians in zip 39503

Competitor

Search similar physicians

City GULFPORT
Zip Code 39503
Specialty FAMILY MEDICINE
City + Specialty GULFPORT + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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