Mazzanti, Gary Bernard

Mazzanti, Gary Bernard is an sole proprietor health care provider with primary practice located at 701 Jordan St Suite A, Shreveport LA 71101-4660. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Mazzanti, Gary Bernard can be contacted via phone (318) 221-6700.

Contact Information

Primary practice address
701 Jordan St Suite A Shreveport LA 71101-4660
Phone: (318) 221-6700
Fax: (318) 221-6701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X MD020779 Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD020779 Louisiana

Profile Details

NPI number 1174629299
LBN Legal business name Mazzanti, Gary Bernard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2006
Last updated Dec 1st, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174629299 NPPES
Louisiana MEDICAID 1399256

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