DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. GARY BERNARD MAZZANTI, M.D.

Active Sole Proprietor

DR. GARY BERNARD MAZZANTI, M.D. is a 207PE0005X healthcare provider located in SHREVEPORT, Louisiana. NPI 1174629299 is currently active in the NPPES registry. Verify at CMS.

207PE0005X · SHREVEPORT, LA

Registration Details

NPI Number
1174629299
Provider Type
Individual
Gender
Male
NPI Issued
Sep 16, 2006 (19.914066907581 yrs)
Last Updated
Dec 1, 2009
Licenses
MD020779 (LA)
MD020779 (LA)
Sole Proprietor
Yes

Practice Information

Address
701 JORDAN ST
SUITE A
SHREVEPORT, LA, 711014660
Browse LA providers · Browse ZIP 71101
Phone
3182216700
Fax
3182216701
Primary Specialty
207PE0005X
207PE0005X
Additional Specialty
Family Medicine

Other 207PE0005X Providers in SHREVEPORT, LA

Name Credential NPI
DR. VICTORIA L EVERTON M.D. 1952339038
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.