MEDICARE: DR. GEORGE NICK GUZZARDO JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	13928	LA
2	207Q00000X	Family Medicine Physician	13928	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760474084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE NICK GUZZARDO JR. M.D.

Provider Business Mailing Address
First Line	:	34 CHATEAU LATOUR DR
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-2021
Country	:	US
Telephone Number	:	504-469-1201
Fax Number	:	504-469-1201

Provider Business Practice Location Address
First Line	:	180 W ESPLANADE AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	KENNER
State	:	LA
Zip	:	70065-2467
Country	:	US
Telephone Number	:	504-464-8015
Fax Number	:	504-464-8538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/26/2013

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Directions to “ DR. GEORGE NICK GUZZARDO JR. M.D.” Practice Location

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